Child's Name *

First Name

Last Name

Child's Birthdate *

Preschoolers must be between 3-5 years of age by August 31, 2024 to participate.

MM

DD

YYYY

Caregiver's Name *

First Name

Last Name

Caregiver's Phone *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Photo Agreement *

Check the box next to your preference below.

I grant Wing Haven, its representatives and employees the right to take photographs of my child in connection with Wing Haven. I authorize Wing Haven, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Wing Haven may use such photographs of my child for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.

I DO NOT grant Wing Haven, its representatives and employees the right to take photographs of my child in connection with Wing Haven.