TimberNook Registration Form

Thank you for registering for a TimberNook program! The form below is mandatory for each child participating in a TimberNook program. If you are new to TimberNook, please go ahead and fill one form out for each child participating. If you have already filled out a form for a previous session, there's no need to submit a new one UNLESS something has changed.

* Required

 Please confirm that you have the correct location selected above to insure your registration is processed.









No
Yes - please list below




Asthma
Heart Problems
Breathing Problems
Physical or Developmental Challenges
Medical Conditions or Issues
Autism
Sensory processing Disorder
None of the Above


No
Yes



No
Yes


No
Yes


I give my consent


I give my permission
I DO NOT give my permission


I give permission for my child's photo to be taken
I DO NOT give permission for my child's photo to be taken


I agree to the policies

My typed full name here is to serve as my legally binding electronic signature on this form and my agreement with TimberNook policies, the liability waiver and consent statements.





IMPORTANT! Please re-confirm that you have the correct TimberNook location selected in the first dropdown box before hitting 'Submit'.