INQUIRE ABOUT OUR NEW KINDERGARTEN PROGRAM. LEARN MORE
Child's Name:
Last Name
First Name
Nickname (if Any)
Date of birth (D.O.B.):
Age :
Medical Concerns:
Allergies:
Potty Trained?:
yesno
Mother's Name:
Phone Numbers:
Phone
Cell Phone
Home Address:
Street Name and No.
Apartment-Unit
City
State
Zip Code
E-mail address:
father's Name:
Last name
First name
Name:
Relation
Physicians Name:
Hospital Preference:
Parent Signature :
Date :
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This Registration is entered into between Baby Stars Inc., a Florida corporation (“us”, “our” or “we”) and the parent or legalguardian identified as “Parent” in the signature block of this Registration (the “Parent”) and the child identified in thisRegistration (the “Child” and together with the “Parent”, “you” or “your”). This Registration will become effective as of thedate we approve the Child for the program in which you enroll the Child (the “Program”). This Registration is subject to(i)the terms and conditions set forth in Exhibit A (the “Terms”) and (ii)any other documents you execute with us withrespect to the Program (the “Riders”), all of which are attached to this Registration and incorporated herein by thisreference. You hereby acknowledge, understand and voluntarily accept the Terms.
Child’s Name (Please Print):
Parent’s Name (Please Print):
Parent’s Signature: