Shine school

Shine farm

Steiner inspired farm workshops
Parent #1 Name*

First NameLast Name
Parent #2 Name

First NameLast Name
Child's Name*

First NameMiddle NameLast Name
Child's Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary E-mail*
example@example.com
Parent #1 Primary Phone Number
Format: (000) 000-0000.
Preferred Start Date
Preferred Care Schedule*
Emergency contact Name and Phone Number
Format: (000) 000-0000.
Exceptional Child Needs
Additional Comments- please state is your child is attending multiple workshops.
.
Should be Empty:

Shine farm