If your child is enrolled in afterschool classes with us, please submit the following form:

Please read and carefully complete our child information and release form for your child/children. This form is required & must be submitted for each child prior to joining us for after school classes.

In addition, parents must join brightwheel, our current platform for daily attendance and communication. You will receive a parent invitation via email, which is necessary to then access and upload your child's information. 

Child's Name *
Child's Name
1. Parent/Guardian *
1. Parent/Guardian
Phone *
2. Parent/Guardian
2. Parent/Guardian
Emergency Contact (other than parent/guardian) *
Emergency Contact (other than parent/guardian)
Phone Number for Emergency Contact *
Phone Number for Emergency Contact
Name of Child's Physician *
Name of Child's Physician
Phone Number for Child's Physician *
Phone Number for Child's Physician
Does your child regularly take any prescribed medication or carry an epipen or allergy related action plan? If so, please list and describe below. If not, please write 'none.'
Schedule, Tuition, and Payment * *
Tuition is non refundable, non transferable and due in full prior to your child attending class. An individual invoice with payment options will be sent to each family. A late payment fee in the amount of $25 will be applied to payments made 3 business days past due and a late payment fee in the amount of $50 will be applied to payments made 5 business days past due. Once the initial deposit is secured, families may request schedule changes, which may or may not be honored, depending on availability.
Consent for Medical Treatment* *
In the case of medical emergency, I understand that every reasonable attempt will be made to contact the Parent(s)/Guardian(s) or another designated emergency contact. However, in the event that I cannot be reached, I give my permission to the Educators of Brooklyn Nature Days, LLC to help my Child and secure emergency medical treatment. I agree to pay for any charges for emergency medical treatment that are not covered by my personal health insurance. This acknowledgement and consent applies for the duration in which my child attends class.
Acknowledgement of Risk* *
II acknowledge that there are risks inherent in any youth activity, including – but not limited to – injury arising from participation in outdoor physical activity. I acknowledge that all risks cannot be prevented, and assume those beyond the reasonable control of the teachers and staff. In consideration of being permitted to participate in Brooklyn Nature Days, LLC, on behalf of myself, my family, my heirs, and my assigns, I hereby release and hold harmless Brooklyn Nature Days, LLC, its teachers and its staff from any liability for injury, loss, or death to the Child. In order to minimize risks to my Child and others, I will take responsibility to make sure that my Child is prepared for all activities, dressed appropriately for the weather, and is in good health for each class. I am also aware that Prospect Park is a public park with rough terrain and wild animals, and open to the general public for various activities. I appreciate and accept that risk and waive any right to pursue legal remedies associated with inherent risks of the park.
Bathroom, Sunscreen, and Bug spray* *
Snacks* *
Media Release*
Consent to Photograph: I do hereby consent and agree that Brooklyn Nature Days, LLC has the right to take photographs and video clips of my child and to use these on the Educator's websites and promotional materials without compensation. I understand my child's name and identity will not be revealed.
Signature *
By signing this form electronically, I attest I am the parent/guardian of the above child and I am the person whose name appears in the box below. I understand and agree to the terms stated and checked on this form.