Summer 2017 Flyer

summer registration form-06

Playsafe Registration

Email Address:

Child's Full Name (required)

Age

Medical concerns:

T-Shirt Size:

Second child's full name

Age

Medical concerns:

T-Shirt Size:

Street Address

City/Zip

Mother's Name

Home/Cell

Work

Father's Name

Home/Cell

Work

Please list at least two persons, beside yourself, whom you authorize to pick up your child

Name


Name of emergency contact if parents are unavailable: (Please give two)

Name

Phone


Playsafe Scheduling

Please fill out a schedule for your child by following these steps before submitting your application:

1.) The following link will download an Excel template for you to schedule your child. Click to schedule!

2.) After completing the schedule, save a copy to your computer.

3.) In the field below, click "Upload" and select the your completed schedule.

Upload completed schedule here: