Clone of Little Bloomers Black Friday Slumber Party Registration

Child’s Full Name*

First NameLast Name

Date of Birth*

Date

Age Group*

Does your child currently attend Little Bloomers?*

YesNo

Does your child have any allergies or dietary restrictions?*

Emergency Medication (EpiPen, Inhaler, etc.)*

Any additional health or behavioural notes?*

Parent/Guardian Name*

Phone Number*

Please enter a valid phone number.

Email Address*

example@example.com

Alternate Emergency Contact Name*

Alternate Emergency Contact Phone*

Please enter a valid phone number.

Please list the name(s) of the adult(s) who are authorized to pick up your child. Only the people listed below will be allowed to pick up your child.*

Please enter name

Phone Number*

Please enter a valid phone number.

Optional: Additional Authorized Adult

Please enter name

Phone Number

Please enter a valid phone number.

Consent & Acknowledgement*

I give permission for my child to attend the Little Bloomers Little Bloomers Holiday workshop series on November 29, December 06 and December 13, 2025.I understand that light snacks will be served and have disclosed all allergies above.I consent to staff providing basic first aid in case of minor injury.I release Little Bloomers Child Care Centre, its staff, and affiliates from any liability arising from participation in this event.I give permission for my child to be included in group photos taken during the event (for internal and social media use).I understand that a late pickup fee of $5.00 for the first minute and $1.00 per minute thereafter will be charged for pickups after 9:00 PM to cover additional staffing costs.

Payment Details

$141.25 CAD per child (includes tax)E-transfer to lbccfranchise@outlook.com

Upload payment confirmation screenshot.*

Little Bloomers Holiday Workshop Series Registration Form