Toddler Playgroup - Meridian Learning

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Toddler Playgroup - June 9:30 - 12:00

June 2, 3
June 9, 10
June 16, 17
June 23, 24

Toddler Playgroup - June

Price:

Number of Children for Toddler Playgroup - June

Please enter a number from 0 to 3.

Toddler Playgroup - July 9:30 - 12:00

July 7, 8
July 14, 15
July 21, 22
July 28, 29

Toddler Playgroup - July

Price:

Number of Children for Toddler Playgroup - July

Please enter a number from 0 to 3.

Coupon

Total

Parent Information

Parent's Name:*

First Last

Parent's Name:

First Last

Mailing address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email address:*

Enter Email Confirm Email

Cell Phone:*

Home Phone:*

Work Phone:

Best Number to Reach You:*

Cell Phone

Home Phone

Work Phone

Children's Information & Photo Release

Photo Release Permission:

I/We give permission for photos/videos to be taken of:

1st Child's Name (June Class):*

First Last

1st Child's Date of Birth (June Class):*

2nd Child's Name (June Class):*

First Last

2nd Child's Date of Birth (June Class):*

3rd Child's Name (June Class):*

First Last

3rd Child's Date of Birth (June Class):*

1st Child's Name (July Class):*

First Last

1st Child's Date of Birth (July Class):*

2nd Child's Name (July Class):*

First Last

2nd Child's Date of Birth (July Class):*

3rd Child's Name (July Class):*

First Last

3rd Child's Date of Birth (July Class):*

while he/she is participating in Meridian Learning activities. I/We understand that photos/video may be published online, in printed materials and/or for other promotional purposes, but only to help document student work and illustrate Meridian Learning programs. I/We hereby waive any ownership rights, as well as any right that I/we may have to inspect or approve the finished product in which a photographic or video image may be used including the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied.

Children's Medical Information

Does your 1st Child (June Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd child (June Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd child (June Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 1st child (July Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd child (July Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd child (July Class) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Emergency Contact:

Emergency Contact Name:*

First Last

Emergency Contact's Relationship to your child:*

Emergency Contact's Address:*

Street Address Address Line 2 City State ZIP Code

Emergency Contact's Phone Number:*

Preferred Hospital:*

Name of Family Physician:*

First Last

Phone Number for Family Physician:*

In case of emergency, do we have permission to administer CPR and/or authorize an ambulance to transport your child(ren) to a hospital?*

Yes

Emergency Contact Acknowledgement:*

By checking the box, you are agreeing that the information provided for Emergency Contact is accurate.

Registration Policy

We regret that we cannot grant refunds for Toddler Playgroup registrations. If we must cancel a class due to low enrollment, your payment will be refunded.
We reserve the right to cancel Toddler Playgroup due to low enrollment. Registrants will be notified via email if class is cancelled.

Parent Agreement

Confidentiality

Meridian Learning is committed to protecting the privacy of all families who participate in our programs, as well as the children in the learning environment. With this in mind, we will not discuss confidential information in the presence of children or other parents. If you wish to discuss sensitive issues pertaining to your child, please contact us via email.

Attendance/Punctuality, Inclement Weather and Make-ups

Whenever possible, please give a two (2) hour notice if you are unable to attend class. We regret that we cannot excuse you from payment or grant refunds for absences. Advanced notice of tardiness is appreciated as it may impact the rhythm of the class. If your child’s class is cancelled due to inclement weather or illness, a make-up class will be offered.

Participant Behavior

We reserve the right to terminate enrollment at any time should a participant’s behavior/needs, consistently and beyond an initial adjustment period, impact the quality of the environment, interfere with the functioning of the class as a whole and/or endanger himself or others.

Children's Information & Photo Release, Children's Medical Information, Emergency Contact, Registration Policy, Parent Agreement Acknowledgement:*

By signing below, you are agreeing that the information provided is accurate and that you have read the Photo Release, Registration Policy and Parent Agreement. My signature below indicates that I agree to all of the above provisions regarding my family’s participation in the program(s).

Parent/Guardian Name:*

First Last

Parent/Guardian Signature*

Parent/Guardian Name:

First Last

Parent/Guardian Signature