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    Safety Village Registration

    Uploaded by

    morgansearles
    The document is a registration form for Safety Village, which provides safety education for children. It requests the child's name, address, emergency contact information, t-shirt size, session preference, and includes liability waiver. It notes that registration must be mailed with payment and signed waiver, and to include a self-addressed stamped envelope to receive confirmation. No refunds are given and more information will be provided by June 1st.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Safety Village Registration

    Uploaded by

    morgansearles
    745 views1 page
    The document is a registration form for Safety Village, which provides safety education for children. It requests the child's name, address, emergency contact information, t-shirt size, session preference, and includes liability waiver. It notes that registration must be mailed with payment and signed waiver, and to include a self-addressed stamped envelope to receive confirmation. No refunds are given and more information will be provided by June 1st.

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    2016

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    The document is a registration form for Safety Village, which provides safety education for children. It requests the child's name, address, emergency contact information, t-shirt size, session preference, and includes liability waiver. It notes that registration must be mailed with payment and signed waiver, and to include a self-addressed stamped envelope to receive confirmation. No refunds are given and more information will be provided by June 1st.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    745 views1 page

    Safety Village Registration

    Uploaded by

    morgansearles
    The document is a registration form for Safety Village, which provides safety education for children. It requests the child's name, address, emergency contact information, t-shirt size, session preference, and includes liability waiver. It notes that registration must be mailed with payment and signed waiver, and to include a self-addressed stamped envelope to receive confirmation. No refunds are given and more information will be provided by June 1st.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    2016 SAFETY VILLAGE REGISTRATION

    This form must be ***Mailed and Postmarked*** and include:


    ***Check to Safety Village and the Signature of the childs own parent on the application
    ***Include a Long (#10) Self-Addressed Business***Stamped Envelope***
    Check for each child in one family may be combined in1 check ($108.00 per child- T-shirt handed out 1 st day)
    Name:_____________________________________School:______________Next Grade in Fall ______
    Address:___________________________________Town:______________Phone:_________________
    Neighbors Name:__________________________________Telephone:__________________________
    (in case child gets sick and we cant reach you)
    Your Cell Phone:__________________________
    Allergies?***___________________________________Email Address:_________________________
    ***For your childs safety, Epipens must be in a fanny pack on your child at all times as we move inside
    and outside frequently and must be able to be accessed by the professional closest to them in an emergency!
    Please check: Boy:______ Girl:______ Size: Small___________ Medium___________ Large:____________
    (Most Kindergarteners order a Small, most first graders order a Medium)
    Session Requested: 8:30_________________10:15________________ Please give 1st and 2nd choice
    Would you like to bring cookies or a treat for graduation on the last day?_________________________
    ***Include a LONG SELF ADDRESSED STAMPED (BUSINESS) ENVELOPE with registration!***
    The undersigned gives permission for his child to participate in the Safety Village program and releases the
    directors and volunteers of Safety Village and the Katie Satkamp Memorial Foundation from any liability
    whatsoever for any injury to person or loss or damage to property sustained by the undersigned or any member of
    his family.
    Signed:___________________________________________Date:__________________________
    Parent of:_________________________________________** Must fill in.**

    If you dont hear from us, your child is enrolled in the session you requested. We will only call if
    there is a problem with your registration. You will receive more information about June 1st! We
    are sorry that there are no refunds. Please keep the attached information! We really look
    forward to seeing you at Safety Village soon.
    Established by the Katie Satkamp Memorial Fund
    at Oak School, 950 South Oak Street, Hinsdale, Illinois 60521
    as a Non-Profit, Tax Deductible Organization
    Mailing Address: Safety Village of Hinsdale, 6230 Cove Creek Court, Burr Ridge, Illinois 60527
    (630) 323-6330

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