Child Registration

Service Time Planning to Attend* 9:30am11:00am

Child Information

First Child’s First/Last Name
First Child’s Gender
MaleFemale
First Child’s Birthday

First Child’s Completed Grade

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Second Child’s First/Last Name
Second Child’s Gender
MaleFemale
Second Child’s Birthday

Second Child’s Completed Grade

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Third Child’s First/Last Name
Third Child’s Gender
MaleFemale
Third Child’s Birthday

Third Child’s Completed Grade

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Fourth Child’s First/Last Name
Fourth Child’s Gender
MaleFemale
Fourth Child’s Birthday

Fourth Child’s Completed Grade

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Fifth Child’s First/Last Name
Fifth Child’s Gender
MaleFemale
Fifth Child’s Birthday

Fifth Child’s Completed Grade

Parent/Guardian Information

Dad/Stepdad/Guardian First/Last Name
Dad/Stepdad/Guardian Cell Phone
Dad/Stepdad/Guardian Email
Mom/Stepmom/Guardian First/Last Name
Mom/Stepmom/Guardian Cell Phone
Mom/Stepmom/Guardian Email

Marital Status of Parents/Guardians

SingleMarriedDivorcedWidowed

Address for Child(ren)

Address
City
State
Zip Code
Do we have permission to take/display photographs of your child(ren)? YesNo
Any other details we should know? (Food allergies, etc.)

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