Sign-up: RIE Wanderland

Presented by Elizabeth Memel, M.A., RIE Associate To ONE family at a time with children from birth to age eight. An Essentially Playing and Growing Outdoors Program

Sign-up Form

Please fill out the following form in order to participate in Wanderland. Submissions are valid up to 24 hours prior to the activity.

Name(s) of Parent(s)

Name(s) of Child(ren

Date of Birth 1

Date of Birth 2

Address

City, State, Zip

Phone

Parent(s) Occupation(s)

PRE-ARRANGED DATES GET SCHEDULED MINIMUM EVERY THREE DAYS IN ORDER TO MAINTAIN BEST SANITARY PRACTICES. ATTENDANCE FOR THIS PROGRAM IS BY DONATION. PAYMENT CAN BE MADE VIA VENMO, FACEBOOK PAY OR ZELLE QUICKPAY POST-SESSION.

PARENT RESPONSIBILITY AGREEMENT:

I understand that during my participation in the RIE® WANDERLAND gathering, at least one parent will be present. I further understand that “Third Street Bodyarts” (DBA of Elizabeth Memel) cannot assume responsibility for the PHYSICAL safety of my child while attending RIE Wanderland, and I agree not to hold “Third Street Bodyarts” or its staff responsible for any event. You may refrain from signing this till after your first visit.

I confirm that I have read, understand, and agree to the above.

Thanks for submitting!

AUTHENTIC BABIES

Sign-up: RIE Wanderland

Sign-up Form

Please fill out the following form in order to participate in Wanderland. Submissions are valid up to 24 hours prior to the activity.

PRE-ARRANGED DATES GET SCHEDULED MINIMUM EVERY THREE DAYS IN ORDER TO MAINTAIN BEST SANITARY PRACTICES. ATTENDANCE FOR THIS PROGRAM IS BY DONATION. PAYMENT CAN BE MADE VIA VENMO, FACEBOOK PAY OR ZELLE QUICKPAY POST-SESSION.

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