Class day and time
Child's Date of Birth
Emergency contact( must be different than number above)
Please list any allergies
Child's school and days/ hours
Please supply us with any information you feel may be important for us to know about your child
How did you hear about Storybook Workshop?
Please list any family members or friends who may pick up your child from class
I have read and agree with the Storybook Workshop refund policy
I allow Storybook Workshop to use my child's photo in promotional materials ( names will not be used)
INDEMNIFICATION AGREEMENT Recognizing and understanding that Storybook Workshop, LLC Classes are physical which could result in injury, the undersigned parent(s) /guardians or the above student understands and accepts his/her responsibility to provide for insurance to cover all personal injury and or property damage which may be incurred or recognizes and accepts that Storybook Workshop, LLC, Crawford Memorial Methodist Church, Neighborhood Cooperative Nursery School, Winchester Cooperative Nursery School and Vinson-Owen Elementary School disclaims responsibility for such personal injury and or damage. TO SIGN: ( please print your name and the date in box).
Please fill out the fields marked with an asterisk.