General Application

Program Name

Child's Name*

Child's Date of Birth*

Parent/Guardian 1 Name*

Address

Email*

Phone Number*

Cell Phone?
YesNo

Parent/Guardian 2 Name

Address

Email

Phone Number

Cell Phone?
YesNo

Child's Physician*

Physician Contact*

Known Medical Conditions, Allergies, and Dietary Restrictions*

(If parent can't be reached, the below are authorized contacts in case of emergency)

Contact 1 Name*

Relationship*

Phone*

Contact 2 Name

Relationship

Phone

Liability Waiver: I understand that these programs operate 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.

I agree/understand*
YesNo

By eSigning below, you are agreeing to the terms and conditions set forth in this document.

Parent/Guardian eSignature*

Today's Date*

Spam Check (A. = 2)*
One + 1 = ?

All fields marked with * are required.

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