Beagle Bay Registration - Please PrintMust be
completed by child’s parent
Child’s Name
____________________________________
Birthdate __________________________
Parent’s Name(s)
____________________________________
____________________________________
Address
____________________________________
____________________________________
Email Address
____________________________________
Phone Numbers
____________________________________
____________________________________
Who has permission to pick up and drop off your child
(must be 18 or older)
____________________________________
____________________________________
Allergies
____________________________________
____________________________________
Additional Comments (favorite toy, snack, etc)
____________________________________
Please sign below:
______________________________________
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