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Snow Day camp WAIT LIST FORM

Child Name *
Child Name
Name of Second Child
Name of Second Child
Name of Third Child
Name of Third Child
Parent/Guardian *
Parent/Guardian
Cell Phone *
Cell Phone
Secondary Parent/Guardian
Secondary Parent/Guardian
Secondary Parent/Guardian Cell Phone
Secondary Parent/Guardian Cell Phone
Waivers
Photo/Video Release *
Photo/Video Release - I understand that Professor Qwbli's will be taking pictures and/or video to use for marketing purposes only. Professor Qwbli's will not release the names of any participant, but may use their image for event promotional purposes.
Late Pick-Up Fee *
I understand that my child must be picked up by the specified time, plus a 15 minute grace period or a $25 Late Fee will be charged.
Emergency Contact
Should we not be able to contact the primary parent/guardian, whom should we contact in case of an emergency?
Emergency Contact *
Emergency Contact
Cell Phone *
Cell Phone