Wilbraham Children's Museum Playgroup Registration

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Please fill out the form below and the Playgroup Coordinator will be in touch with you.



Email Address:
Parent's Name Attending Playgroup:
Street Address:
City:
State:
Zipcode:
Phone Number: (optional)
Child's name Birth Date
Child's Name: Birth Date
Child's Name: Birth Date
Please check off up to 3 different choices for playgroup day and time. In the space provided below please specify which is your first, second and third choice.

Monday 9:30-11:00 Monday 11:00-12:30 Monday1:00-2:30 Monday 3:00-4:30 (baby group) Tuesday 9:00-10:30 Tuesday 1:00-2:30 (baby group) Tuesday 3:00-4:30 Wednesday 9:30-11:00 Wednesday 11:00-12:30 Wednesday 1:00-2:30 Wednesday 3:00-4:30 Thursday 9:30-11:00 Thursday 11:00-12:30 Thursday 1:00-2:30 Thursday 3:00-4:30 Friday 9:30-11:00 Friday 11:00-12:30

Would you like to be a playgroup leader? Yes/No
Additional comments, requests or questions. Also specify your first, second and third choice here.

2004-2005 Registration Fee to be paid by ALL MEMBERS (including Leaders, Board of Directors, Museum Officers and Volunteer Coordinators). Registration Fees are pro-rated for members joining after the first session:

Wilbraham Residents $25.00
Non-Residents $30.00

Session Fee: $25.00 for each 10 week session. Please pay this amount at the BEGINNING of each 10 week session and give it to one of the leaders of your playgroup.