Fini Kids | Fini Health & Wellness

Step 1

Participant & Family Information

Tell us about the child or teen registering for Fini Kids.

Participant Name Date of Birth Age Home Address City State ZIP

Parent/Guardian 1

Name Relationship to Child Phone Number Email Address

Parent/Guardian 2 Optional

Name Relationship to Child Phone Number Email Address

Emergency Contact Must be different from parent/guardian above

Name Relationship to Child Phone Number Alternate Phone

Educational Information

School Name Current Grade

Active IEP?

Yes No

IEP Case Manager School District

Step 4

Waiver, Media & Medication Authorization

Please review each authorization and provide the parent/guardian information requested.

2026 Fini Kids Program Waiver / Release

I authorize my child to participate in the Fini Kids Health & Wellness Program, including scheduled program activities, recreational fitness activities, educational programming, community outings when applicable, and approved transportation. I acknowledge the program waiver/release language contained in the registration packet.

Parent/Guardian Name (Printed) Electronic Signature Date

Photo & Media Release

Please select one:

Yes, I give permission for my child to be photographed and/or recorded for the uses described in the registration packet. No, I do not give permission for promotional or marketing use.

Parent/Guardian Name (Printed) Electronic Signature Date

Medication / Sunscreen Administration

Sunscreen authorization

Yes No

Will medications be administered?

Yes No

Medication	Amount to be Given	Time to be Given

Parent/Guardian Electronic Signature Date

Step 5

Review the Completed PDF

This is the actual registration packet layout. Click directly into any highlighted field on pages 6-12 to make a last-minute change before submitting.

Editable PDF reviewYour changes here update the online form automatically, so the final downloaded and emailed PDF will match what you see.

Loading your PDF review…

What happens after you submit?

We will fill the official Fini Kids registration packet with your answers, download the completed PDF to your device, and email the completed packet to Fini Health.

Security verificationComplete the checkbox before submitting this registration.

Registration Form

Before You Begin

Participant & Family Information

Parent/Guardian 1

Parent/Guardian 2 Optional

Emergency Contact Must be different from parent/guardian above

Educational Information

Medical & Health Information

Diagnoses or Conditions Check all that apply

Communication, Supports & Interests

Primary Communication Check all that apply

Communication Style Check all that apply

Supports, Accommodations & Care Needs

Child Strengths & Interests

Waiver, Media & Medication Authorization

2026 Fini Kids Program Waiver / Release

Photo & Media Release

Medication / Sunscreen Administration

Review the Completed PDF