Parents and Tots Forest School Spring 2023 Parents and Tots Registration Form Parents and Tots Norfolk Forest School Registration Form Pilot program for children under 3 and their parent. Each 2 hr session is $20; 4 sessions for $75 Select days for your child to attend March 6th – 10 a.m. Simcoe; 1 p.m. Delhi March 7th – 10 a.m. Waterford; 1 p.m. Pt. Dover March 20th – 10 a.m. Simcoe; 1 p.m. Delhi March 21st – 10 a.m. Waterford; 1 p.m. Pt. Dover Participant Name * Name First First Last Last Age * Date of birth * Sex * Male Female Mailing address * Mailing address Mailing address Mailing address Town Town Province Province Postal Code Postal Code Parent / Guardian Name Name First First Last Last Place of employment Email address Home phone Work phone Mobile phone Emergency contact Name Name First First Last Last Relationship to participant Home phone Mobile phone Medical Doctor's name Child's health card number Does your child have allergies? Yes No If yes, please explain Emergency Procedures or Specific Instructions for above Does your child have any health problem or limitations that would affect their participation in programs? (hearing, speech, physical or emotional delays) Is your child on any medications? Yes No If yes, provide details My child will be responsible for her/his own medication I agree Other information about your child you wish to provide Payment The program cost is $20 per day, or all four days for $75. The program runs at times indicated above. Payment is due upon registration Payment options * Cheque E-transfer E-mail address to send e-transfers to: info@naturescalling.ca Cheques should be mailed to: Nature’s Calling Environmental Education P.O. Box 995 Simcoe, ON N3Y 5B3 Cancellation and Refund Policy If a day’s program must be cancelled due to educator illness, a full refund for the day will be issued. Norfolk Forest School will make every effort to notify parents (by email, telephone, and/or text) as soon as possible so alternate arrangements for their child can be made. Authorization I understand that there is risk involved in participating in an activity or program and I acknowledge that my choice to register my child in the above named program brings with it the assumption by me of those risks. I consent to my child’s photo being taken using photograph or video. I further understand and authorize that pictures taken may be used for promotion (i.e. social media, print media, NCEE publications and website, and other forms for advertising and promotion). I hereby waive any right to inspect or approve the finished product or advertising or other copies that may be used in connection therewith or the use to which they may be applied. I understand that this material remains the property of Nature’s Calling Environmental Education. Yes No Sign by typing your full name * Date If you are human, leave this field blank. Submit