Creative Play Studio Registration Form

Creative Play Studio Registration Form

Register your child for engaging early learning activities and specify your preferences.
Parent / Guardian Information
Parent/Guardian Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child Information
Child’s Name

First NameLast Name
Age
Pronouns
Any diagnoses or developmental information
Sensory needs or accommodations
Learning strengths
Areas of support (fine-motor, early literacy, regulation, etc.)
Allergies or safety considerations
Program Selection
Choose Format
Choose Program Option
Session Location
Location choice
Suggested location address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Scheduling Preferences
Preferred Days
Preferred Times
Materials & Comfort
Does your child have any sensory sensitivities (noise, textures, movement, etc.)?
Are there materials you prefer we use or avoid (paint, clay, glue, etc.)?
Parent/Guardian Signature
Parent/Guardian Signature
Date

MonthDayYear
Date
Should be Empty: