2023 Winter Session

Haddonfield Central School

Thursdays Noontime Enrichment Program

3rd and 5th grades

Register here!

Student Information

Name of School *

Student name (First Last) *

Gender *

Male

Female

Student Age *

Does your child(ren) have any health or concerns we should be aware of? * (i.e. asthma, allergies (food or animal),hearing or vision difficulties, special needs etc.?) *

No

Yes

Please use this space to provide any other information you feel helpful about your child.

Marketing Release

We want your Vet in Training to be Facebook famous, but we need your permission first. Please review the terms and select the consent option below which applies to all students you are registering for this program.

I grant permission to HousePaws Mobile Veterinary Service and HousePaws Vets in Training Program, its employees and authorized representatives to take photographs and/or video of me and/or my son(s)/daughter(s), to copyright, use and publish the same in print and/or electronically. Student name information will not be used without advance permission from parents. I agree that HousePaws may use such photographs, videos or stories including me and/or my son/daughter with or without our names and for any lawful purpose, including for example such purposes as social media, publicity, advertising, and other Web content. *

No

Yes

Parent/Guardian name *

Parent/Guardian signature *

clear

Parent/Guardian Information

Name *

Cell Phone # *

Email Address *

Address *

City *

State *

Zip *

Parent/Guardian #2 *

Parent/Guardian 2--Cell Phone # *

Emergency Contact *

Emergency Contact--Cell Phone # *

Registration & Refund Policy Information

Vets In Training Payment & Refund Policy

Acknowledgement of registration, payment and refund policies. Please see the link above to review these policies. *

Yes

Registration Order & Payment Information

Register one student for $85 / 6 week session *

6 Week Program Registration ($85)

Current Total:

$0.00