To enroll your child in the Cool Climate Kids Club - return the following form to Peterborough Green-Up. 

By signing this form you are giving permission for your child to receive our Cool Kit 
(filled with fun and informative materials suitable for the entire family) 
and regular postcards listing community events and interesting facts.

______________________________

Yes!  My child would like to join the Cool Climate Kids' Club!!

Child's Name:	_____________________________________________________

Parent's Name:	_____________________________________________________

Address:		_____________________________________________________
			
			_____________________________________________________

Postal Code:		_____________________________________________________

My child would be interested in appearing with Cool Captain Climate on a CHEX TV segment featuring climate-friendly tips!    Yes        No 
Our phone number is___________________________________________________
				
Parent's Signature:	_____________________________Date:____________________


If you have any questions, contact 										
	Jackie at Peterborough Green-Up, 										
	745-3238 or email climate@greenup.on.ca


                                             PETERBOROUGH GREEN-UP
                                             (lower level Peterborough Square)
                                             360 George St. N. Unit 42
                                             Peterborough, ON
                                             K9H 3E6
                                             Phone: (705) 745-3238
                                             Fax: (705) 745-4413