Family Registration Form | Rainbow Literacy and

First name

Last name

Email

Phone

Address

Birthday of parent

Year

Month

Day

Name and birthday of child(ren)

Allergies of any children

Have you or your child attended any of our other programs?

How did you learn of our program?

If referred, by whom?

Do you have a goal/outcome from this program?

Do you consent to receive emails from Rainbow Literacy regarding programs in the future?

Do you consent to share any photos taken during the program?

Who is authorized to sign out your child(ren) if required?

Do you feel you have any reasons that could be difficult to access our programs? Eg. transportation, childcare, time or date of program etc.