Wild Rose Farm 2024, 'Afternoon Farm & Forest' Program Registration

Wild Rose Farm

'Afternoon Farm & Forest' Program 2024

Monday, Tuesday, Wednesday & Thursday, 2:45-5:30 p.m.

hearty snack & crafting materials included

Winter: February 5 - April 11 (no program 2/26-2/29)

Spring to Summer: April 22 - June 6 (no program 5/27)

Autumn to Winter: September 9 - December 19 (no program 10/14, 10/28,11/11 & 11/18-11/21)

*Please NOTE that we follow the High Mowing School Academic Calendar. If your children/s Academic Calendar has different sheduled Holidays, or teacher work days, we will do our best to help you schedule a 'make-up' after or credit your balance due for these missed program afternoons.

Registration & Program Payment

Registration Monday Afternoons

$30.00

Registration Tuesday Afternoons

$30.00

Registration Wednesday Afternoons

$30.00

Registration Thursday Afternoons

$30.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

INVOICING: We email Invoices, for the balance due, via QuickBooks to the primary email address listed on this Registration Form. Unless otherwise agreed upon the payment for the first Invoice payment will be due 15 days after the first day of the program, and the balance will be due 15 days prior to the end of the program.

Please check all that apply to your current circumstances. We will apply a multiple day discount, if applicable, to your balance due. If requested we will contact you to coordinate a payment plan and/or financial support, and answer any further questions..

Single invoice

Please invoice me, for the total balance due, in one invoice.

Payment Schedule

Please contact regarding setting up a payment schedule.

Financial Support

Please contact me to coordinate financial support.

Multiple Afternoon registration, per Seasonal Session, discount

Please apply the 10% multiple afternoon registration (for each session) discount.

Anything else?

Child's Name*

First NameLast Name

Birthdate*

Child's current Grade in School

Parent or Adult Caregiver*

First NameLast Name

Relationship to child*

Emergency Contact:*

YesNo

Primary Phone Number*

MobileLandline

*

Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code

Additional Parent or Adult Caregiver (optional)

First NameLast Name

Email*

example@example.com

Emergency Contact:

YesNo

Relationship to child

Primary Phone Number

MobileLandline

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Does your child follow any dietary guidelines or have any food preferences?*

if yes, please provide notes belowno

Dietary notes

Is your child currently taking any regular medications, including carrying an inhaler or an Epi-pen?*

if yes, please provide notes belowno

Medical notes

Is there anything else you would like to share with us about your child? Please note how you would like to be contacted. Thanks!