Create a Field Trip Friends Account

Name

Username*

Contact Info

E-mail*

About Yourself

Password*

Repeat Password*

Child 1 Information

Child 1 Name*

Child 1 Age*

Child 1 Birthday*

Child 1 Special Needs/Allergies

Child 2 Information

Child 2 Name

Child 2 Age

Child 2 Birthday

Child 2 Special Needs/Allergies

Child 3 Information

Child 3 Name

Child 3 Age

Child 3 Birthday

Child 3 Special Needs/Allergies

Parent/Guardian Information

Mom's Name*

Mom's Phone #*

Dad's Name*

Dad's Phone #*

Mailing Address*

Emergency Information

Emergency Contact Name & Relationship*

Emergency Contact Phone Number*

Child Doctor's Name*

Doctor's Phone #*

Medical Insurance Policy #

Other Information

Do you have membership anywhere? (Zoo, Sea Life Park, etc.)

List names of friends that you want to be in the same class with.

Is it alright to text you? YesNo

Waiver Agreement

I agree.*
I, as the parent, Agency Representative or Legal Guardian of the child/children stated above, will be solely responsible for this child/children at all times during Field Trip Friends, Inc. (FTF) programs & hereby hold FTF & its locations harmless & not responsible for any & all damages, injuries, or loses that may be sustained while in the care of FTF and its locations. I have read FTFs Policies & Procedures, Registration, & Tuition information at www.fieldtripfriends.com & accept the terms stated within. Due to the unique design & independent creation of Field Trip Friends, Inc. (FTF), I, the undersigned, understand that submission of this registration creates a confidential relationship between me, the undersigned, & FTF. I further understand & agree that I am obligated to remain loyal to FTF by not disclosing its trade secrets, original ideas, & private locations to a potential competitor or use them to establish or create my own similar program. I understand that this type of intellectual piracy by implication or otherwise will be a breach of the confidential relationship between me & FTF. I give permission to Field Trip Friends, Inc. (FTF) to photograph &/or videotape the adults & children named above & allow use of the resulting photos/videos for FTF's education, evaluation, marketing, documentation, &/or sharing amongst members, including posting on the FTF Facebook site and/or website.

Send these credentials via email.