Colorful Motion Project

Welcome to the Colorful Motion Project! Please complete the form below to register your child and provide the necessary information to create the best experience possible.

Note: Participants must be supervised by a parent or guardian during all activities. We are not medical professionals, and this program is strictly for play, social interaction, and developmental fun. Children 3 to 15 years old are eligible to participate.

By completing this form, you agree to receive email invitations to future events hosted by the Colorful Motion Project.

All medical and sensitive information collected in this form will be kept confidential and protected in compliance with privacy standards.

Full Name of Child: *

Date of Birth:*

Date

Age of Child:*

Gender:*

MaleFemaleNon-BinaryPrefer not to say

Primary Diagnosis or Conditions:*

Does this child have any food allergies? (If so list them below)*

What are a few examples of foods or snacks your child enjoys?(Please provide a few options that your child likes to eat during events or snack breaks.)*

Does your child have any food aversions or dislikes?(Optional: Let us know if there are foods your child prefers to avoid.)*

Does this child require special accommodations? (If so list them below)*

T-Shirt Size:*

Food Allergies and/or Special Acommodations:( If there is none please enter none)*

Do you have additional children to register?*

YesNo

Full Name of Parent/Gaurdian:*

Relationship to Child?*

Phone Number:*

Please enter a valid phone number.

Email:*

By Providing your email, you agree to receive information about future events and other important information

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name:*

Relationship to Child:*

Emergency Contact Phone Number:*

Please enter a valid phone number.

Please use this space to provide additional information*

I understand that my child must be supervised by me or a designated guardian at all times during program activities.*

YesNo

I understand that the Colorful Motion Project is not administered by medical professionals, and the activities are intended solely for play, social interaction, and developmental engagement.*

YesNo

I understand that food may be served during program activities, and the Colorful Motion Project is not responsible for any allergic reactions or incidents related to food consumption.*

YesNo

I give permission for the use of my child’s photos/videos for promotional purposes.*

YesNo

I acknowledge that participation in these activities is voluntary and at my own risk, and the organization is not liable for any injuries that may occur.*

YesNo

I acknowledge that participation in these activities is voluntary and at my own risk, and the organization is not liable for any injuries that may occur.*

YesNo

I understand that the information provided in this form will be used to invite my family to future events via email.*

YesNo

I understand that all medical and sensitive information provided in this form will be kept confidential and protected in accordance with privacy standards.I understand that the information provided in this form will be used to invite my family to future events via email.*

YesNo

Signature

Date

Please verify that you are human*