ONLY A LEGAL PARENT/GUARDIAN MAY REGISTER A CHILD.
Information in this section is about the child/children who you are registering for Parents' Day Out. You can register up to 5 children using this form. Please e-mail Alison Jenkins (firstname.lastname@example.org) after you have registered to add additional children to your registration.
For "Preferred Days," choose only as many days as you are registering for (above)
Enter information about who, in addition to the parents/guardians listed on page 1, should be contacted in the event of an emergency or illness during PDO hours. We will contact the parent/guardian first, then the following individuals in the order they are listed. These individuals will also be permitted to pick up the child in the absence of the parent/guardian.
We require that the parent or guardian of each PDO participant consent to the child's participation in the PDO program. The electronic signature below will be binding as your actual signature. By signing this form you indicate your agreement with the following statements: