Mini Medics Registration – Little Medical School

Registration Form

Mini Medics at the Gandy Civic Center

December 21 and/or December 22

Times: 9:30 AM - 10:30 AM

(Click here to sign the waiver and consent. You will upload this in the registration form below)

Waiver of Liability and Photo Consent

Child Information

Child's Name(Required)

First Last

Age(Required)

Additional Child (name and age)

Additional Information

Your Name(Required)

First Last

Relationship to Child(Required)

Phone(Required)

Email(Required)

Waiver of Liability and Photo Consent

Max. file size: 5 MB.

Check out

Choose your program from the list below:(Required)

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Thank you!

We will be in touch soon with important information about this pop-up event. If you have any questions, please contact Kristina at (813) 863-1896 or kristina@littlemedicalschool.com