Natick Cooperative Playgroup
INSTRUCTIONS: Please right click on your mouse and then hit the PRINT option. Please print ALL 3 pages of the Registration form.
Natick Cooperative Playgroup 2010-11 Registration Form
Natick Cooperative Playgroup Location: First Baptist Church (13 Common Street, next to the post office on the Natick Common) Phone: (508) 650-9422 Website: www.natickcooperativeplaygroup.com E-mail: registrar@natickcooperativeplaygroup.com Current Member ______ New Member _______ (Please check one). Parents' Names: ___________________________________________ Address: ______________________________________ ___________________________________________ Phone Number: _________________(mandatory for membership)
If you would like to receive Natick Cooperative Playgroup event information and updates by E-MAIL, please provide an e-mail address below. E-MAIL Address: (Print)_______________________________ Note: Email addresses will be for member use and event information only. They will not be distributed to any outside group.
The Annual Membership Fee is $125.00* per family for one session each week. This fee is applicable to families joining up until January 1, 2011.
Please make checks payable to Natick Cooperative Playgroup. Checks will be cashed monthly beginning in July. You may forward your registration form and payments to:
Natick Cooperative Playgroup
C/O Beth McElaney
I assume all risks to myself and my children arising out of the use of the facilities and participation in Playgroup. I release the Natick Cooperative Playgroup and its members from all liability from the use of Playgroup facilities. Signed: __________________________________ Dated: _______ Please indicate your first, second, and third choices by using 1,2,3. All Ages Sessions: ___ Monday AM (9:30-11:30 a.m.) ___ Thursday AM (9:30-11:30 a.m.) ___ Tuesday AM (9:30-11:30 a.m.) ___ Friday AM (9:30-11:30 a.m.) If you would like to register for more than one session, please please note that on your form. The cost for 2 sessions per week is $250 per family. You will be contacted regarding which day you have been assigned. Names of Children Attending Date of Birth Food Allergies ________________________ ________ ___________ ________________________ ________ ___________ ________________________ ________ ___________ Names of Other Children not attending regularly Date of Birth ________________________ ____________ ________________________ ____________ Please include the names of all children. Expectant mothers should write "new baby" and the approximate due date. Other children not in your family who will be attending playgroup on a regular basis must pay an additional membership fee and have a separate form completed. Registration is conducted in the order in which registration forms are postmarked and received as follows: Current Member registration is through July 15th, 2010. Open registration will begin July 16th, 2010.
The Natick Cooperative Playgroup Guidelines and a confirmation letter will be mailed in late August/early September.
New members: Who told you about NCP? ______________________________________________________________
