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ENROLL
FLORENCE SKIDADDLES

Registration is quick and easy! Simply submit the registration form below and we will have you set up and ready to go when you need us! Once you are registered at one Skidaddles, you can use all of our locations for no additional registration fee!

Here’s all we need to get you started in addition to the form below:

PARENT HANDBOOK

IMMUNIZATION FORM

Enrolling Parent/ Guardian Name

Parent/ Guardian Email

Relationship to Child

Parent/ Guardian Phone

Employer

Street Address

City

Region/State/Province

Postal / Zip code

Second Parent/ Guardian Name

Second Parent/ Guardian Email

Relationship to Child

Second Parent/ Guardian Phone

Employer

Street Address

City

Region/State/Province

Postal / Zip code

CHILD INFORMATION

Child Name

Gender

Birthdate

Check any that apply

Allergies

Dietary Restrictions

Health/ Medical Condition

Special Conditions

Please explain any additional information concerning your child

SECOND CHILD INFORMATION - IF APPLICABLE

Second Child Name

Gender

Birthdate

Check any that apply

Allergies

Dietary Restrictions

Health/ Medical Condition

Special Conditions

Please explain any additional information concerning your child

THIRD CHILD INFORMATION - IF APPLICABLE

Third Child Name

Gender

Birthdate

Check any that apply

Allergies

Dietary Restrictions

Health/ Medical Condition

Special Conditions

Please explain any additional information concerning your child

EMERGENCY INFORMATION

Parents cannot be listed as emergency contacts. In the event of an emergency and I am unable to be reached, I authorize the following person/s to pick up my child(ren). At least one person must be within one hour of the center/home and should be at least 18 years of age.

Emergency Contact Name

Relationship to Child

Phone

Emergency Contact Name

Relationship to Child

Phone