City Kids Registration Form

Child One

Child's Name

Child's Birthday

Please list any allergies:

Optional

Child Two

Child's Name

Child's Birthday

Optional

Please list any allergies:

Optional

Child Three

Child's Name

Child's Birthday

Optional

Please list any allergies:

Optional

Child Four

Child's Name

Child's Birthday

Optional

Please list any allergies:

Optional

Child Five

Child's Name

Child's Birthday

Optional

Please list any allergies:

Optional

Household Information

Parent or guardian:

This address will receive a confirmation email

Phone

Does this phone number receive text messages? Yes No

Parent or guardian:

Optional

Phone

Optional

Does this phone number recieve text messages?

Optional

Yes No

Address

I would like more information about volunteering in City kids.

Optional

Yes No

I would like more information about infant baptism.

Optional

Yes No

Is there anything else you'd like us to know when caring for your child(ren)?

Optional

Description

Filling out this form will help us be ready when you bring your child to City Kids for the first time!

City Kids Registration Form

Description

Please Fix the Following