Beagle Bay Registration - Please Print

Must be completed by child’s parent

 

Child’s Name

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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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