Little Wild Ones with Explorers 2022-23

Explorers Application for Little Wild Ones Program

2022-23
Explorers offers Little Wild Ones (LWO) program year round and in all weather at our location East of Saskatoon.

Fees:

$400 deposit to hold spot due upon accpetance into LWO.

$50 for each daily session. Following Catholic School Calandar with extended winfer breaks.

Hours: 9:00 am-3:00 pm

Eligibility: Students must be 4 by November 30, 2022. Up to 8 years of age.

Location: TimberNook Saskatoon https://goo.gl/maps/F5y62tPWijUh1Gzr6

We want to learn more about your child and your family! Please fill out the complete application and you will recive a follow up phone call once it has been reviewed.
Child's Name: *

First Name Last Name
Gender: *

Male Female
Date of Birth: *

Month Day Year
Date
Child's name that they will use for printing/reading:
EX: Eddie not given name Edward
Please select first class chose: *

Monday and Wednesday
Parent/Guardian Contact Information:
Guardian #1 Name: *
Guardian email *
Guardian Cell Phone: *

Area Code Phone Number
Guardian Home Phone:

Area Code Phone Number
Guardian #2 Name:
Guardian Email:
Guardian Phone:
Please state any shared custody, if applicable:
(Divorced/separated with shared bi-weekly custody)
Child's primary Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Do your children have health issues? If so please describe: *
Do your children have allergies? If so list here. *
ie: NONE, peanuts, dairy,
Do your children have any physical, social, or emotional challenges we should be aware of? If so describe here: *
ie: none, shy when meeting new people,
Two other people to contact in case of emergency if parents cannot be contacted:
First Emergency Contact's Name *

First Name Last Name
Release for Pick ups *

Yes this person can pick up No this person cannot pick up
Relationship to Child: *
Cell Phone: *

Area Code Phone Number
Home Phone:

Area Code Phone Number
Second Emergency Contact's Name *

First Name Last Name
Release for Pick ups *

Yes this person can pick up No this person cannot pick up
Relationship to Child: *
Cell Phone: *

Area Code Phone Number
Home Phone:

Area Code Phone Number
Please list others that can pick up here:
Please provide any further information relating to your child that would be helpful in understanding and caring for your child:
What are some things your family enjoys doing outside? *
What is your families' favorite season and/or type of weather and why? *
What are you hoping your child will gain will attending TimberNook Saskatoon? *
Signature

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Should be Empty:

Explorers Application for Little Wild Ones Program

Parent/Guardian Contact Information: