General Application

General Application

Find Us Outside
Program Name
Preferred Days
Child's Name*

First NameLast Name
Date of Birth*
Parent/Guardian 1 Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Parent/Guardian 2 Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Child's Physician
Physician's Phone Number

Area CodePhone Number
Known medical conditions, allergies or dietary restrictions:*
If either parent cannot be reached, the following person(s) are authorized to be contacted in case of illness, accident or emergency:
Emergency Contact Name*

First NameLast Name
Relationship to the child
Phone Number*

Area CodePhone Number
Emergency Contact Name 2

First NameLast Name
Relationship to the child
Phone Number

Area CodePhone Number
Liability Waiver: I understand that this school operates entirely outdoors and that there are risks which naturally occur whenever children are playing outside. I release Find Us Outside, Inc., its teachers, and its Board of Directors from any liability for injuries that might occur as a result of my child attending any Find Us Outside programs. My child is in good physical health and I will provide appropriate clothing for the weather.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature*
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: