Registration – Nelipots in Nature

Registration Form

First Name

Last Name

Email *

Phone

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

What would be your preferred method of contact?PhoneEmailFacebook Messenger

How many Children you wish to enroll?

Child Information

Mini NeliPre SchoolKindergarden

Child Name

Date of Birth

Child Gender

Emergency Contact Name

Emergency Contact Number

Minor is:LeftyRighty

Any allergies or special notes for your child?

User Role

Can we take images of your Child/Children for our marketing purpose?YesNo

I agree with the Code of Conduct

I agree with the Liability Waiver

I agree with the Voting Policy