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After-School Classes - Spring 2024
Parent/Guardian Name
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How did you find out about after-school classes at Awbury?
Intro to Archery & Wilderness Skills, March 12-April 30 (ages 8-12)
Quantity
$184
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Regular rate
0
1
1
$46
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Scholarship rate (please get approval first)
0
1
1
$0
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Wissahickon Charter student
0
1
1
Natural Wisdom, March 13-May 1 (ages 8-12)
Quantity
$184
-
Regular rate
0
1
1
$46
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Scholarship rate (please get approval first)
0
1
1
$0
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Wissahickon Charter student
0
1
1
OWLS, March 14-May 2 (ages 13-18)
Quantity
$220
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Regular rate
0
1
1
$60
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Scholarship rate (please get approval first)
0
1
1
Child's Name
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First Name
Last Name
Child's Pronouns
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For example: he/him; she/her; they/them
Child's Date of Birth
*
(mm/dd/yyyy)
Child's age as of March 2024
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Child's Physician's Name
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Child's Physician's Phone Number
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Health Insurance Provider
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Health Insurance Policy Number
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Medications Currently Used
*
Illnesses, Medical Conditions, or Allergies
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Medical Care Consent
*
I do hereby consent to any medical care and the administration of anesthesia determined by a physician to be necessary for the welfare of my child while said child is under the care of Awbury Arboretum and I am not reasonably available by telephone to give consent. I am the lawful guardian of the child listed and there are no court orders now in effect that would prohibit me from conferring the power to consent upon another person.
Agree
Do not agree
Is there anything special about your child's learning style or physical abilities that you would like to share with us?
Please list who has permission to pick your child up:
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Emergency Contacts - Phone numbers and relation to child:
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Photo Release
*
Photographs taken of my registered child may be used in Awbury exhibits, published in local news outlets and in Awbury publications, or published on the Awbury website or other digital media.
I agree and give photo release permission
I disagree and do not give photo release permission