2025 Worrier to Warrior

2025 Worrier to Warrior Registration
4 Week group for ages 9 to 12

Wednesdays Oct. 29 through Nov. 19, 2025 from 5:30 pm to 7:00 pm

Meetings are held at 20240 S. Eagle Road, Meridian, ID 83642
Parent or Legal Guardian Information
Consenting Parent/Legal Guardian*

First NameLast Name
Consenting Parent/Legal Guardian Cell Phone*

Area CodePhone Number
Consenting Parent/Legal Guardian Email*
example@example.com
Second Parent/Legal Guardian

First NameLast Name
Second Parent/Legal Guardian Cell Phone

Area CodePhone Number
Second Parent/Legal Guardian Email
example@example.com
Family Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Information
Child's Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Current Grade Level*
Current School*
Emergency Contact Information
Emergency Contact Name(if parent or guardian is not avaliable)*
Emergency Number*

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Other Information
How did you hear about Worrier to Warrior?
Health Information
It is our policy to contact the parent/legal guardian as soon as possible in the event of a serious accident or injury. If contact information has changed between registration and the first day of the group, please notify Winslow Institute at (208) 370-5236 or email wanda@winslowinstitute.com

We believe you are the best judge of your child's health and we trust you to determine whether your child is healthy enough to attend.

If your child is exhibiting symptoms of fever, breathing difficulites, intestinal distress, or general flu-like symptoms please call to let us know of your child's absence.

Once your child's mood, appetite, and activity are normal and they have been fever free for 24 hours without a fever reducer, we will be happy to have them resume group activities.
Is the child free from infectious disease or conditions?*

YesNo
All fileds are required below. If nothing applies, please put "NONE" in the box. Thank you.
Any physical, mental or other condition that would require special attention or medication while attending?*
List any allergies (ex: bees, peanuts, dairy)*
Attendee Release
Attendee Release (List anyone, including parents, to whom your child can be released. Child will not be released to an adult not listed here.)*
I authorize Winslow Institute to use my child's picture, testimony, and video in any promotional material (web, print, or media).*

YesNo
Be certain to enter your email address correctly on the registration form to receive confirmation.
By hitting submit and typing my initials, I confirm that I am the parent or legal guardian of the above named attendee, and that I am over the age of 18.

In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named child by authorized personnel.

I understand that the above named child will only be released to the names listed above.

I understand that I am responsible for picking up my child ontime and an additional charge will be assessed if I am late.

I certify that my child has my permission to attend the Worrier to Warrior group and participate in all activities.

I am aware that if my child's behavior consistently disrupts the learning of other attendees, I will be notified.

I am aware I will receive an email with further details regarding drop-off and pick-up once my registration is complete.
Signature*

Clear
Electronic signature, please initial*
Payment Information
You can either pay with credit card, debit card, or a PayPal account. Depending on your browser's security settings, you may need allow redirects and pop-ups from http://winslowinstitute.com in order to be taken to the payment window.

If there are no seats available when you attempt to register, please call (208) 370-5236 or email wanda@winslowinstitute.com
*
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Worrier to Warrior Registration $270.00
Wednesdays Oct 29 to Nov 19 from 5:30 pm to 7:00 pm

Total $0.00
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2025 Worrier to Warrior Registration

Parent or Legal Guardian Information

Child's Information

Emergency Contact Information

Other Information

Health Information

Attendee Release

Payment Information