Full Name*
Address*
City*
State*
Zip Code*
Email Address*
Home Phone Number*
Cell Phone Number
Work Phone Number
Full Name
Relationship to Child/Children
Address (if different from above)
Email
Home Phone Number
Phone Number*
Alternate Phone Number
Discounts: Most programs are eligible for a discount when you register for two or more in the same order. You will automatically receive this $15 discount off the cost of the second and any additional program. Some programs are exempt from this offer.
Program Times: Unless noted, all programs begin at 9am. Therefore, morning drop-off is scheduled from 8:15–9:00am. Unless noted, programs end at 5pm with afternoon pick-up scheduled from 5:00–5:15pm. By continuing, you agree to pay Schoolhouse of Wonder 50 cents for every minute after 5:20 that you am late for pick-up. Outdoor School programs run from exactly 9:00am to 4:00pm.
Early pick-up option: You have the option of an early pick-up at scheduled 3:00–3:15pm. Barring emergencies, this is the only time prior to the end of the scheduled day that we are able to release children for pick-up.
Please specify which, if any, days you wish to pick your child/children up at 3:00pm
Authorization for Emergency Medical Care: Should an accident or emergency occur that requires your child to receive medical care, you hereby give permission to the physician selected by Schoolhouse of Wonder staff to hospitalize and/or secure proper treatment for your child, except as noted below. You agree to be liable for these noted exceptions.
Insurance Information* (policy name and number, company, & exceptions to treatment)
How did you hear about Schoolhouse of Wonder?
Please tell us of any physical, medical, or emotional conditions your child(ren) might have that will require our special attention. Please specify particular challenges, allergies and associated medications, or special needs, if any: