Real Life Kids Registration

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I’m New
Connect
Watch
Events
Ministries
Give

If you are a human and are seeing this field, please leave it blank.

Fields marked with an * are required

Child 1's Name *

Child 2's Name

Child 3's Name

Child 4's Name

Child 5's Name

Child 1's Gender *

Male
Female

Child 2's Gender

Male
Female

Child 3's Gender

Male
Female

Child 4's Gender

Male
Female

Child 5's Gender

Male
Female

Child 1's Birth Date *

Ex: 03/12/2013

Child 2's Birth Date

Child 3's Birth Date

Child 4's Birth Date

Child 5's Birth Date

Child 1's Grade *

Child 2's Grade

Child 3's Grade

Child 4's Grade

Child 5's Grade

The parent information below is only for the parents who are living with the child(ren) listed above.

Dad's/Stepdad's Name

Dad's/Stepdad's Cell Phone #

Dad's/Stepdad's Preferred Email

Mom's/Stepmom's Name

Mom's/Stepmom's Cell Phone #

Mom's/Stepmom's Preferred Email

Marital status of above individual(s) *

Married
Single
Widowed
Divorced

Address for child(ren) *

City *

State *

Zip / Post Code *

Home Phone (if applicable)

May we have permission to photograph and display photographs of your child(ren)? *

NOTE: Infants-6th Graders MUST be picked up at the classroom by an individual 16 years or older with matching security badge.

If you lose security badge, return with photo ID to the Welcome Dock or Welcome Hut for a reprint of badge.

If you don't receive a successful submission message after clicking "Submit," make sure all required fields are completed.

HELPFUL LINKS

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