Play and Learn Group Registration Form

Upon completion of the Ingham Play & Learn Enrollment Form, you will be directed to the Registration Form. If the group you wish to attend is full, please add your family to the Wait List and you will be contacted when there are openings. Contact 517.244.1267 for questions. 

Parent/Legal Guardian 1 Information
Help for First and Last Name First and Last Name
Help for Street Address Be sure to add the house, building, or apartment number.
Parent/Legal Guardian 2 Information
Help for Street Address Be sure to include the house, building, or apartment number.
CHILD 1 Information (under 5 years of age)
MM/DD/YYYY
Child 1 Race (check all that apply) Help for Child 1 Race (check all that apply) Demographic data is based upon collected by grant funders
Child 1 Gender at Birth
Has Child 1 received Early On or Great Parents Great Start (GPGS) services?
CHILD 2 Information (under 5 years of age)
MM/DD/YYYY
Child 2 Race (select all that apply)
Child 2 Gender Assigned at Birth
Has Child 2 received Early On or Great Parents Great Start (GPGS) services?
CHILD 3 Information (under 5 years of age)
MM/DD/YYYY
Child 3 Race (check all that apply)
Child 3 Gender Assigned at Birth
Has Child 3 received Early On or Great Parents Great Start (GPGS) services?
Family Information
Choose the school district where you reside.
Where did you hear about our program?
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Register now for the playgroup you wish to attend. 

Choose only one group per family. Register on the Wait List if your group of choice is currently full.  

 

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