No-School Days (for 5 y.o. and up) 2023-2024
Minimum of 4 kids needed for the program to take place
Student Name
First Name
Middle Name
Last Name
Age
Parent Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Emergency Contact Name (different from the parent name)
*
Emergency Contact Phone Number (different from the parent number)
*
E-mail
*
Authorization for First Aid Treatment: in the event that parents/guardians named on this form cannot be reached, I authorize officials of the Blue Giraffe Education Center to consent on my behalf, to provide emergency treatment for my child
*
I agree
Please list allergies if any and anything we should know about your child/children
Dates:
My Products
prev
next
( X )
Camp Day
$
95.00
Quantity
Second Child (Sibling) 10% Off
$
79.20
Quantity
Total
$
0.00
Credit Card
Submit
Should be Empty: