King's Kids Wednesday Registration
Please fill out this form and click submit.
Family lnformation
Parent's Name
*
Email
*
This address will receive a confirmation email
Cell Phone
*
Additional Emergency Contact Number:
*
What is the best way to contact you? * :
*
Please select all that apply.
Phone/Text
E-mail
Child Information
Child # 1 Name:
*
Gender:
*
Please select all that apply.
Male
Female
Age Group:
*
Please select one option.
Ages 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Select Option
Ages 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Birth Date:
*
Special Needs / Allergies?
Child # 2 Name:
Gender:
Please select all that apply.
Male
Female
Age Group
Please select one option.
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Select Option
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Birth Date:
Special Needs / Allergies
Child #3 Name:
Gender:
Please select all that apply.
Male
Female
Age Group:
Please select one option.
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Select Option
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Birth Date:
Special Needs / Allergies:
Child #4 Name:
Gender:
Please select all that apply.
Male
Female
Age Group:
Please select one option.
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Select Option
Age 3 - Pre K
Kindergarten - 2nd grade
3rd - 5th grade
Birth Date:
Special Needs / Allergies:
Submit
Description
Please fill out this form and click submit.
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