Childrens Program Registration Form

Please fill out this form to register for an upcoming retreat or program.
  • HomeCellWork/Other 
    Add a new row
  • What, if any, medical concerns (gluten intolerant, allergies, etc.) would be important for the staff to know about your child?
    I consent to photos of my child being included on The Center for Spirituality and Enrichment website and in the newsletter. No child's name will be published.
  • In Case of Emergency Contact(s) (Name & Phone Number):
  • Drop OffPick Up 
    Add a new row
    (Child will not be allowed to go with anyone else)