Health Forms

For all drop-off PUDDLESTOMPERS Programs, a physical within 18 months and full immunization record must be provided upon registration. Please contact your healthcare provider for a copy of this form. It can be emailed to sara@puddlestompers.com or sent to us at;

1 Bridge St.
Suite 105
Newton, MA 02458

 

Consent Form

Name *
Name
Emergency Medical Consent *
I, parent or legal guardian of the child named above, give consent for my child to attend PUDDLESTOMPERS Nature Exploration Drop-off Programs. As a parent/guardian I understand that my child’s participation will include various outdoor and indoor activities. I acknowledge that injuries may occur as a result in the participation of this program, and I accept that consequence. I understand that in order for my child to attend PUDDLESTOMPERS Drop-off Programs, I must provide Emergency Medical Consent.
Emergency Medical Contact *
Emergency Medical Contact
Other than parent/guardian listed above
Emergency Contact Phone Number *
Emergency Contact Phone Number
Sunscreen/Insect Repellent Consent
I, parent or legal guardian of the child listed above, give consent for my child to attend PUDDLESTOMPERS Nature Exploration Drop-off Programs. As a parent/guardian I understand that my child’s participation will include various outdoor and indoor activities. As such, I acknowledge that in order to maintain my child’s health and safety, sun protection and insect repellent are necessary.