Elementary Etiquette Society Event Registration
  1. Please use this convenient form to register for our events. Be sure to fill in all required fields marked with (*).
  2. Your Name:(*)
    Please type your full name.
  3. E-mail:(*)
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  4. Event Information:

  5. Event:(*)
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  6. Date of Event:(*)

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  7. Location:(*)
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  8. Child's Information:

  9. Child’s Name:(*)
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  10. Nickname:(*)
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  11. School:(*)
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  12. School Location:(*)
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  13. Child's Age:(*)
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  14. Child's Grade (last semester):(*)
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  15. Sibling’s Name:
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  16. School:
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  17. Grade:
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  18. Age:
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  19. Sibling’s Name:
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  20. School:
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  21. Grade:
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  22. Age:
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  23. Sibling’s Name:
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  24. School:
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  25. Grade:
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  26. Age:
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  27. Parental Information:

  28. Mother's Name:(*)
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  29. Mother's Contact Number:(*)
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  30. Mother's E-mail:(*)
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  31. Father's Name:(*)
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  32. Father's Contact Number:(*)
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  33. Father's Email:(*)
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  34. Emergency Contact Information:

  35. Emergency Contact Name:(*)
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  36. Number:(*)
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  37. Pediatrician's Name:(*)
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  38. Pediatrician's Number:(*)
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  39. Allergies (food, medicines, animals, or other):
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  40. Helpful Information:

  41. Manner Concerns:(*)
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  42. Child's Strength:(*)
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  43. Child's Weakness:(*)
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  44. Favorite Food:(*)
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  45. Favorite Dessert:(*)
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  46. Favorite Color:(*)
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  47. Favorite Prizes:(*)
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  48. Favorite Party Theme:(*)
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  49. Favorite Game:(*)
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  50. Our Regards:

  51. To whom may we send a "Thank You" card for your discovery of our programs?
  52. Full Name:
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  53. Liability Release:

    I hereby agree to accept and assume all risks of any and all injuries sustained by me and/or my child/children relating to or arising out of participation to any and all events sponsored by or are in relations to the Elementary Etiquette Society and all its parties. I agree to release and discharge the Elementary Etiquette Society and all its parties from and against any and all cost, claims, demands, losses, expenses, damages or causes of action (including, but not limited to: attorney’s fees at all judicial levels) that I, my spouse, my child/children, or anyone in my household including all employees living in or out have now or may have in the future for any personal, negligence, property damage, loss or other liability (including, but not limited to liability for medical malpractice arising out of or relating to any treatment or care from employees, nurses, doctors, hospitals or other medical units, for any injury sustained by myself, my spouse, my child/children, or anyone in my household including all employees living in or out. I give my consent that Elementary Etiquette Society and its party members to give basic first aid care to minor injury to myself and/or my child/children if needed.

    Photograph Release:

    Photograph Release Elementary Etiquette Society /Munchkin Manner Dinner Socials/Camps/Programs/Book Signings/Private Lessons Locations vary I grant the Elementary Etiquette Society, the right to take photographs of my child/children and/or myself in connection with the above-identified subject. I authorize the Elementary Etiquette Society, its assigns and transferees to copyright, use and publish the same in media, print, video and/or electronically. I agree that the Elementary Etiquette Society or media representatives Elementary Etiquette Society gives permission to may use recordings, photographs, or videos of my child/children and/or myself with or without names and for any lawful purpose, including, but not limited to purposes as publicity, illustration, advertisement, and web content. I have read and understand the above.

    The electronic signature below acts as my authorization of my consent to these release forms.
  54. Electronic Signature:(*)
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  55. Choose Item or Enter Amount Below
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  56. Total
    0.00 USD
  57. Or Enter Other Payment Amount:
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  58. Captcha:
    Captcha:
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