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Squirrels and Chipmunks - November 16, 2023

2023 REGISTRATION FORM

Please complete one form per program date.

***Please provide us an email address that you routinely check - it is what we will use for program communication.***

Thank You!

Participant Information

Please fill out this form for each of your children if you have multiple participating in programs.

Is this your child’s first program with us in 2023?

Yes

Permission and Waiver Forms / Policies and Procedures

If this is your child's first program at Fern Hollow in 2023, you need to fill out one Fall 2023 Waiver and Permission Form AND one Fall 2023 Policies and Procedures Form per child. Please click on the links below. You may complete the forms after you submit your registration.

Fall 2023 Waiver and Permission Form

Fall 2023 Policies and Procedures

Child's Full name

First Name

Last Name

Child's Date of Birth

Current grade (2023-2024 school year)

Electronic Signature

Child's guardian consent

First & Last Name

First Name

Last Name

Contact Phone

Contact email

Verify Email

Date

(mm/dd/yyyy)

Are you a Fern Hollow Member?

Yes, I'm a member

No, I'm not a member

Public Fee *	Quantity
$15 - Squirrels and Chipmunks - November 16, 2023 - Public Fee
$110 - One Year Membership ($100) + Member Fee ($10) Squirrels and Chipmunks - November 16, 2023

Member Fee *	Quantity
$10 - Squirrels and Chipmunks - November 16, 2023