Registration Checklist
Only fill out and submit this information if you have received confirmation from Katy about an open spot for your child.
You can email completed forms to putneyplace@gmail.com, or use the form uploader below.
Registration Checklist: In order to enroll in our program, you must complete and return the following documents:
Registration From Please make sure to contact the director before filling out this form. You can email her at putneyplace@gmail.com
Medication Release Form (if your child will need medication administered during aftercare)
Immunization Records and record of annual physical and health history including name and telephone number of the child's primary health care providers (to be obtained from health care provider and delivered to Exec. Director of the program)
Completed and signed Tuition Agreement
Copy of court orders on custody and visitation arrangements (if applicable).
Vacation Request Form (available to full-time students only)
Hold Harmless Agreement: In the event that parents wish to employe Pumpkin Patch Staff members for private baby-sitting, they will need to complete this form