Prime Time Registration Form

In case of emergency, please list phone numbers where parents/guardians can be reached while your child is at Prime Time.

Individuals picking your child up must be authorized in writing. Phone calls will not work in accordance with State law. Please list individuals authorized to pick-up your child, including yourself.

Medical Information

I authorize Prime Time to provide care for my child. In the event my child is injured or becomes seriously ill and I cannot be reached, I authorize the Prime Time staff to seek medical attention and I authorize any and all hospitalization, medical, dental and/or surgical treatment deemed advisable by the circumstances. I understand any of the foregoing care will be at my expense.

By adding your name and checking "I agree", you are legally signing this form.