Child Enrollment & Waiver

This form collects required information for your child to participate in Salish Kids Club sessions. Please complete one form per child.

This information helps sessions run smoothly so kids can settle in quickly and safely when they arrive.

Enrollment & Waiver

Child Information

Child's First name

Child's Last name

Child's Date of Birth

Used to ensure age-appropriate activities and supervision.

Pronouns

Optional.

Preferred Name / Nickname

Optional: Child Photo (for staff identification only)

This photo is used only for internal staff identification and will not be shared publicly.

Medical & Safety

Please share any information that may impact your child’s participation or safety during sessions.

Does your child have any allergies?

Yes

No

If yes, please describe the allergy, severity, and any required response.

Materials are age-appropriate and guidance is provided throughout each session.

Does your child have any medical conditions we should be aware of?

Yes

No

If yes, please describe.

Additional notes we should know to support your child

Emergency Contact

Emergency contact information (in case a parent or guardian cannot be reached).

Emergency Contact Full Name

Emergency Contact Phone

Relationship to Child

Drop-Off / Pick-Up

Who is authorized to pick up your child?

Please list names. ID may be required if unfamiliar.

Parents are welcome to remain nearby at the SEA Discovery Center during sessions.

Agreement & Consent

These agreements help keep sessions safe, organized, and comfortable for all kids attending.

I acknowledge that participation involves inherent risks and agree to release and hold harmless the program, its staff, and venue except in cases of gross negligence.

I authorize staff to seek emergency medical care for my child if I cannot be reached.

We may occasionally take photos or videos during activities for program promotion (e.g., website or social media).

Yes, I grant photo/video permission

No, I do not grant permission

Images are used respectfully and without identifying information.

Parent Certification

I certify that the information provided above is accurate and complete.

Parent / Guardian First Name

Parent / Guardian Last Name

Parent/Guardian Signature

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Parent / Guardian Email

Must match booking email.

This enrollment and waiver remains valid for all Salish Kids Club sessions attended unless updated or revoked in writing.

Reserve Your Spot

Select a date to reserve your child’s spot. Enrollment and waiver are required once and saved for future bookings.

Ages 7–12 • 60 minutes • All materials included

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