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 Registration Form printed from website

Fall 2008/Spring 2009

Location:          Natick 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: (PLEASE 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.

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
Debbie Knapik

 8 Huntington Street

Natick, MA 01760

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.)

___ Monday PM (3:00-5:00 p.m.)                              

If you would like to register for more than one session, please choose an AFTERNOON session as your second session.  The cost for 2 sessions per week is $250.00/family.                 

You will be contacted regarding which day you have been assigned.

New Parent Session

___ Friday (1:00-3:00 p.m.)

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 June 30^th, 2008.

        Open registration will begin June 30th, 2008 and run through June 2009.

The Natick Cooperative Playgroup Guidelines and a confirmation letter will be mailed in late August/early September.