Pre-Cotillion Membership Fee

US$50.00 FREE shipping

Registration /Membership Fee is $50 annually. Membership fee goes towards uniform and materials.

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ENROLL HERE:

The Little Royals Pre-Cotillion Program: Enrollment Application

Sister 2 SisterLV & Brother 2 BrotherLV

Ages: 6-7 years old

Location: Las Vegas County Libraries / Recreational Facilities

Annual Enrollment Fee: $50/year

Full Name of Child(ren) *

Date of Birth *

Primary language spoken at home *

Preferred Name (Nickname) *

Email address *

Age *

Gender *

Boy (brother2BrotherLV)
Girl (Sister 2 SisterLV)

Patent / Guardian Full Name *

Relationship to child *

Cell Phone Number *

Work Number *

Email Address *

Home Address *

City, State, Zip Code *

Cell phone *

III. Emergency Contacts & Authorized Pick-Up Please list two individuals (other than parents/guardians) who are authorized to pick up your child or be contacted in an emergency. *

Contact #1 FULL NAME *

Phone # *

Relationship *

Contact #2 FULL NAME *

Phone number *

Relationship *

IV. Medical & Dietary Information As our program includes "Snack Time Elegance," please be specific regarding dietary restrictions. Does the child have any food or environmental allergies? [ ] Yes [ ] No If yes, please list allergies and reaction severit *

No
Yes

Does the child require an EpiPen? *

Yes
No

Are there any medical conditions, behavioral diagnoses, or special needs instructors should be aware of? *

Yes
No

V. Program Agreements & Permissions Please initial next to each statement: *

Curriculum Consent: I understand that The Little Royals is a structured etiquette and daycare program. I consent to my child participating in daily activities including manners training, creative arts, and supervised play. *

Add check mark

Photo/Media Release: I grant permission for Sister 2 SisterLV/Brother 2 BrotherLV to use photographs or videos of my child for promotional flyers, website banners, and social media. *

Add check mark

Medical Release: In the event of an emergency, I authorize the program directors to seek immediate medical treatment for my child if I cannot be reached. *

Add check mark

Financial Agreement: I agree to the annual $50 enrollment fee, which covers program materials, crafts, and snacks for the year. *

Add Check Mark

VI. Signature By signing below, I certify that all provided information is accurate and I agree to the terms of The Little Royals Pre-Cotillion Program. Parent/Guardian Signature: *

Date *

Printed Name: *

Pre-Cotillion Membership Fee

ENROLL HERE:

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