Form Designer

2023 Family Activities Form

Please submit one form per family. We will keep this information on file for the entirety of 2023.

Family's Last Name *

Please list each child's name, birth date, gender, and grade (if applicable). *

Do any family members have dietary restrictions or allergies? *

Is there any medically relevant information (conditions, medication, assistance) that staff should be aware of? *

Emergency Contact
Please complete the following fields to ensure we are contacting the appropriate individuals in the event of an emergency.

Please list the emergency contact's s name, phone number, and relationship to child. *

Authorized Pick Up List
Please complete the following fields to ensure we are releasing your child(ren) to the appropriate individuals

Please list the authorized pick up individual's name, phone number, and relationship to child. *

Click here to view the Release Form.

By checking this box, I hearby acknowledge that I have read the Release Form and I understand and agree to the terms releasing claims and legal rights. *

Your Name *

Your Email Address *

Submit