Laker Playgroup Registration

Register

2024 Winter/Spring Laker Playgroup

Dates: February 7, 14, 21, 28 | March 6, 13 | April 3, 10

Days/Time: Wednesdays from 10 - 11:30 a.m. (8 classes)

Where: ULS campus - meet outside Manegold Lower School

Cost: $240 includes one child and a maximum of two adults.
Additional sibling: $195; must meet the minimum age requirement of the program and must be accompanied by an additional adult.

Every child who attends must be registered.

Please note:

Late enrollment is possible, space permitting.
No refunds given after the first day of Laker Playgroup.
Laker Playgroup will be held indoors and outdoors depending on the activity and weather.
Bring your own drink and snack, as well as sunscreen and appropriate outdoor clothing/footwear.
Please bring a change of clothes just in case :)

Child Name*

Birthdate*

Gender of Child*

Allergies, Medications and/or Health Plan*

If none, please type N/A

Would you like to register another child?*

2nd Child Name (if applicable)

Birthdate of 2nd Child

Gender of 2nd Child

Allergies, Medications and/or Health Plan

If none, please type N/A

Mother/Guardian Name*

Email*

Cell Phone Number* - -

Father/Guardian Name

Cell Phone Number - -

Would you like to add an alternate caregiver? *

Caregiver Name (if different from parents/guardians)

Cell Phone Number - -

Address*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Photo/Video Release*

Photo/Video Release: Laker Playgroup students and caregivers may be photographed or videotaped during class. We may choose to use these photos/videos in social media, on our website, or in other marketing materials without using full names. By selecting YES, I consent to the use of photos/videos of my child and waive all claims for compensation.

E-Signature: I understand that I am enrolling my child in Laker Playgroup.*

Today's Date*

Additional Sibling Fee*Additional Sibling (+$195.00)

Additional sibling must meet the minimum age requirement of the program and must be accompanied by an additional adult.

Total Amount Due:$240.00

Payment Method:*

Payment Notes/Additional Info:

Send Myself a Copy

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