Geneva Lake Women's Association and Lake Geneva Jaycees

2018 LAKE GENEVA

SAFETY TOWN REGISTRATION FORM

Information About Safety Town

DATES:  June 11 - June 15, 2018

LOCATION: Lake Geneva Middle School, 600 Bloomfield Road, Lake Geneva. 

CHILD AGE REQUIREMENT:   Your child must be entering 5K kindergarten in the Fall to attend. 

CLASS SIZE:  Each session (morning and afternoon) has two classes.  Each class has a maximum of twenty (20) students. 

REGISTRATION FEE: $35.00 per child. One form must be submitted for each child being registered. A PayPal link is included on the form.  This form cannot be submitted without payment.

A limited number of scholarships are available for those with financial need; please contact LG.Safetytown@gmail.com for more information.

CANCELLATION REFUND: Registration fee  (less $5.00 processing charge) will be returned if cancellation is received up to three weeks in advance of the program start date. 

YOUR CHILD MUST BRING:  Your child must bring their own bike helmet with their name on it.  Your child may leave the helmet at the school for the week. If your child does not bring a helmet, they may miss fun activities. There is a limited supply of "Loaner" helmets but be advised that they may not be available.

REGISTRATION CONFIRMATION:  A confirmation/reminder email will be sent approximately two weeks prior to start of Safety Town.   

REGISTRATION ENDS:  Once classes are filled to capacity.  No late registrations will be accepted - ANY REGISTRATION AFTER MAY 28, 2018, WILL NOT BE GUARANTEED A SAFETY TOWN SHIRT. LAST DAY TO APPLY IS JUNE 1, 2018

NEED HELP (Necesita ayuda)?  Please contact: LG.Safetytown@gmail.com

Preferred Session - Morning or Afternoon (Note-Morning classes fill up fast!) *

Information About Your Child

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Child's Gender *
Child's T-Shirt Size *
Child's City *
 
Child's State *
 
Child's Zip Code *
 
In the box below, please list any foods your child must avoid (e.g., peanuts, dairy).
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Children in Safety Town learn about dogs, and have contact with a dog. If your child has a dog allergy which may limit contact with a dog, please describe below the type of dog exposure and contact that is acceptible for your child, and any special instructions. If no dog allergy, please leave blank.
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You child will learn one important family phone number in class.  Your child may also make a craft item in class - such as a braclet - using this phone number.  This phone number should be the most important phone number the child will need to contact their parent or guardian.
When possible, we try to place your child in a class with their friends and family members. In the fields below, please indicate the first and last name of someone you would like your child to be in class with.
Using the buttons below, please indicate the school your child will be attending this Fall for 5K kindergarten.
 *
 

Parent/Guardian Information

Emergency Contact Information

(Emergency Contacts MUST be Available During the Hours Your Child is in Safety Town)

Registration Payment

Please select to begin payment process, then press CONTINUE. *