Bodywise Health Education Enrollment
This is the form for enrolling in Bodywise Health Education. You will need to fill out this form for each child and then follow the link at the end to finish your registration and pay the class fee.
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What is the first name of the child that will be attending? *
What is the last name of the child that will be attending? *
What are the child's pronouns? (She/her, they/them, he/him, ...?) *
What is the child's date of birth? *
What is your full name (the adult who's completing this registration)? *
What is your email? *
What is your phone number? *
Does the child have any food allergies? (Snacks will be provided at each class.) If so, please describe AND contact me at rae@scandentlearning.org at least 10 days before the class. *
Does the child have any special needs that will require accommodations? If so, please describe AND contact me at rae@scandentlearning.org at least 10 days before the class. *
What is your child's experience with health/sex/puberty education? (Taken a class before? Talked about it at home? Comfortable or uncomfortable? Etc?) *
Do you or your child have any particular questions or topics that you hope to see covered in this class? (If you wish to provide more detail than what fits here, please email me at rae@scandentlearning.org.)
What is the full name of a parent/guardian or other adult who can be contacted in case of emergency? *
Emergency contact phone number? *
Is there anything else I should know about your child?
Thank you for enrolling in Bodywise Health Education. To complete your registration, click Submit below, and then follow the instructions to pay for your class. If you are registering for more than one student, please click Submit, then complete this enrollment form for each student, and submit payment. Thank you.
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