the Registration Form - Kortright Centre for Conservation

Transcription

the Registration Form - Kortright Centre for Conservation
9550 Pine Valley Drive, Woodbridge ON, L4L 1A6 (905) 832-2289 www.kortright.org
2015 KORTRIGHT FOREST SCHOOL REGISTRATION FORM
Participant’s Name____________________________________________ Date of Birth ________/_______/_______ Sex_____
Month
Day
Year
Parent/Guardian Name________________________________________ Address______________________________________
City ____________________________ Postal Code_______________ Email ________________________________________
Home phone______________________ Business phone_________________________ Cell phone________________________
Person dropping off________________________________ Person picking up________________________________________
*Forest School runs 9:00 am – 12:00 pm daily. Each session is $500. Forest School is for potty trained children ages 2 ½
to 5 years old.
Spring Session: Weekdays, Monday June 8 – Friday June 19, 2015
Fall Session: Weekdays, September 28 – Friday October 9, 2015
We must receive REGISTRATION FORMS and FEES for your child to be considered as registered. A separate form must be
filled out for each child being registered. Please ensure you have COMPLETELY filled out the application form, image release
form and the Waiver form in order to secure your reservation.
Emergency Contact :_________________________________________________
Relationship: ______________________________________Tel: _______________________________________________
Medical Information
Family Doctor: ____________________________________ Tel:________________________________________________
Ontario Health Card No: ____________________________ Activity Restrictions:___________________________________
_____________________________________________________________________________________________________
Medical Restrictions: ___________________________________________________________________________________
Behavioural/Emotional concerns:___________________________________________________________________________
Allergies or Dietary Restrictions: __________________________________________________________________________
Other Relevant Information that will assist us in making your child's Forest School experience as successful and rewarding as
possible:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
How did you hear about Kortright Forest School ?____________________________________________________________
Method of Payment
Amount paid: _____________ Cash (in person only) VISA
Cheque made payable to: Toronto and Region Conservation
M/C
AMEX
Card #: __________________________________________ Expiry Date: ______________________________________
Signature: ________________________________________
CANCELLATION POLICY: Written notification of a cancellation must be received. Cancellations made at least four weeks
before the start of your session will receive a refund of 75 per cent of the fees. Cancellations made within a four-week period will
not receive a refund. There is no refund for days missed.
Please email completed forms to [email protected] or Fax them to 416-661-6610 Attention: Caroline MacGillivray
For Forest School questions and inquiries please call 416-667-6295 ext. 602
Also refer to Waiver Form, Image release form and Forest School FAQ Form

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