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Playground Drop-In
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Open Playground
Tuesdays in May 3:30-4:45
For children 0-3 with a trusted adult
Child Information
Child's name:
Date of birth:
Address:
Parent Information
Name:
Cell Phone Number:
Email:
Name:
Cell Phone Number:
Email:
*
Select Tuesdays attending
May 13th
May 20th
May 27th
General Waiver
By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature in reference to the Photo/Video release and general waiver. The electronic signature will be equally as binding as the original manual paper signature.
*
I hereby give permission for my child to participate in the playground drop-in that I have registered them for. I release Kaplan Nursery School, Sutton Place Synagogue, or any of its sponsors, benefactors or employees from any liability arising out of any injury to my child as a result of their participation. I understand that my child must be supervised by an adult at all times while on the playground.
I hereby give permission for my child to participate in the playground drop-in that I have registered them for. I release Kaplan Nursery School, Sutton Place Synagogue, or any of its sponsors, benefactors or employees from any liability arising out of any injury to my child as a result of their participation. I understand that my child must be supervised by an adult at all times while on the playground.
Electronic Signature:
Today's Date:
Wed, May 14 2025 16 Iyyar 5785
