Welcome to Kidstown!

Welcome! Please register yourself and your kid(s) and then let the front desk staff know that you submitted your form!

PARENT/GUARDIAN'S Information

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Full Name of 2nd parent/guardian IF that person is allowed to pick up the child

CHILD #1

Child's First & Last Name

*

Child's Birthdate

*

Child's School Grade

*

Please select one option.

Toddler (0-3) Pre-K Kindergarten 1st 2nd 3rd 4th 5th

Child's School Name

*

Special Needs or Allergies?

Child can be in pictures used for church website, flyers, etc.

*

Please select one option.

Yes No

CHILD #2

Child's First & Last Name

Child's Birthdate

Child's School Grade

Please select one option.

Toddler (0-3) Pre-K Kindergarten 1st 2nd 3rd 4th 5th

Child's School Name

Special Needs or Allergies?

Child can be in pictures used for church website, flyers, etc.

Please select one option.

Yes No

CHILD #3

Child's First & Last Name

Child's Birthdate

Child's School Grade

Please select one option.

Toddler (0-3) Pre-K Kindergarten 1st 2nd 3rd 4th 5th

Child's School Name

Special Needs or Allergies?

Child can be in pictures used for church website, flyers, etc.

Please select one option.

Yes No

CHILD #4

Child's First & Last Name

Child's Birthdate

Child's School Grade

Please select one option.

Toddler (0-3) Pre-K Kindergarten 1st 2nd 3rd 4th 5th

Child's School Name

Special Needs/Allergies

Child can be in pictures used for church website, flyers, etc.

Please select one option.

Yes No

Description

Welcome! Please register yourself and your kid(s) and then let the front desk staff know that you submitted your form!

Please Fix the Following

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