Tiny Creative Kids Next Steps Readiness Form

Tiny Creative Kids Program

Next Steps & Readiness Form
Child's Information
Participant Name

First NameLast Name
Birth Date

MonthDayYear
Parent/Guardian Information
Parent / Guardian 1

First NameLast Name
Parent 1 Cell Number
Format: (000) 000-0000.
Parent / Guardian 2

First NameLast Name
Parent 2 Cell Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
E-mail
example@example.com
Has your child participated in any un-parented programs before?
Has your child been to The Park before?
Please let us know if there is anything specific we should know about your child?
Why would you like your child to join our program?
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Should be Empty:

Tiny Creative Kids Program