Tiny Trailblazers Registration

Tiny Trailblazers Registration

Please complete this form. If you are not a member, please also complete the waiver and media release on the next page.
Caregiver Name

First NameMiddle NameLast Name
We encourage as many family members as you would like as long as there is at least one adult present! All children attending over the age of 10 months old must register and pay.
Child #1 Name

First NameMiddle NameLast Name
Child age
18 months-5 years old
Child #2 Name

First NameMiddle NameLast Name
Child age
18 months-5 years old
Caregiver E-mail (@arizona emails are not accepted)
Phone Number

Area CodePhone Number
Please enter your insurance provider information:

Insurance Information is required.
Who is your Insurance Provider?
Required Field
What is your Policy Number?
Required Field

Anything you wish to share about your child(ren)?
*TRAK welcomes children of all abilities.
If you are NOT a current TRAK member, please also read and then sign the following waiver, required for all programs and tours of our property.
Names of all participants covered by this waiver:
This includes caregiver and child(ren).
Parental/Legal Guardian Name, Printed
Parent/Legal Guardian Signature
Date:
Media Release

I hereby grant or deny permission for photographs or video recording of myself or child(ren) to be used for promotional purposes:
Media Permission
Parent/Legal Guardian Signature:
Are you a TRAK Member?

Tiny T's Member Payment for One Child$98.15

Tiny T's NonMember Payment for One Child$123.89

Tiny T's Member Payment for Two Children$195.98

Tiny T's NonMember Payment for Two Children$247.48

Tiny T's MILITAY Member Payment$88.63

Tiny T's MILITARY Non-Member Payment$116.17

Total $0.00

Please enter your insurance provider information: