2020 Child Registration for Building Beloved Community Beyond the Binary

Parent/Guardian Information

Name

Please enter your email below. Please use an email that you check regularly. We will be sending your confirmation to that email along with other important information.

This address will receive a confirmation email

Phone

Address

There is no charge for childcare, however there is a charge for lunch if you choose to have your child eat a lunch we are providing. If you are bringing your child(ren) please register them below.

Child One

Name

Age

Allergies

What else should we know about this child?

Lunch Options Bring own lunch Gluten Free - Egg salad with baby spinach wrap Gluten Free - Turkey with baby spinach and tomatoes wrap Gluten Free - Vegan wrap with hummus and an assortment of vegetables Roast Beef with lettuce and tomato wrap (contains gluten) Vegetarian - with an assortment of vegetables and cheese wrap (contains gluten) Turkey with lettuce and tomato wrap (contains gluten)

Child 2

Name

Age

Allergies

What else should we know about this child?

Lunch choices Bring own lunch Gluten Free - Egg salad with baby spinach wrap Gluten Free - Turkey with baby spinach and tomatoes wrap Gluten Free - Vegan wrap with hummus and an assortment of vegetables Roast Beef with lettuce and tomato wrap (contains gluten) Vegetarian - with an assortment of vegetables and cheese wrap (contains gluten) Turkey with lettuce and tomato wrap (contains gluten)

Child 3

Name

Age

Allergies

Lunch options Bring own lunch Gluten Free - Egg salad with baby spinach wrap Gluten Free - Turkey with baby spinach and tomatoes wrap Gluten Free - Vegan wrap with hummus and an assortment of vegetables Roast Beef with lettuce and tomato wrap (contains gluten) Vegetarian - with an assortment of vegetables and cheese wrap (contains gluten) Turkey with lettuce and tomato wrap (contains gluten)

What else should we know about this child?

Child 4

Name

Age

Allergies

What else should we know about this child?

Payment

Child care is free however we do ask that if you are able please pay for your child(ren)'s lunch. If you will be paying at the door please enter 0 in the credit card choice and then enter your amounts in the Pay at door section.

Payment by PayPal or credit card

Pay at door 1 child 10.00 2 children 20.00 3 children 30.00 4 children 40.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2020 Child Registration for Building Beloved Community Beyond the Binary

Description

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