Kingdom Kids Registration
Child's Name
Date of Birth
Age (at beginning of session)
Grade Completed
My Child will attend (check one of the following)
Tuesdays & Thursdays
Tuesdays Only
Thursdays Only
Guardian(s) Name
Address
City
Zip
Home Phone
Work Phone
Cell Number
E-Mail
Emergency Contact (If Guardians Are Unavailable)
Name
Address
City
ZIp
Home Phone
Cell Number
Please inform us if any other information has changed (allergies, emergency numbers, etc.)
SUBMIT
Thank you for registering for the Kingdom Kids Fall Semester.