KC Registration Tuesday PM
Please note: Childcare for this event is only available for infants through 5th grade.
*
Child
First Name
*
Child
Last Name
*
Child
Birth Date
* Are there any allergies or special needs of which we need to be aware?
* Age/Grade (Tuesday PM KidCare)
Select one
Infant to 24 months [No longer available]
Age 2-3
Pre-K to Kindergarten (Age 4-5)
School Age (1st through 5th grade)
If your age group is full, select this option to be added to the waitlist
* For which Tuesday Evening class is the PARENT registering?
Select one
DivorceCare
GriefShare
Celebrate Recovery
Rooted
Life Group
New Group Launch
* I give my consent for my child to play outside on the Pathway playground.
Select one
Yes
No
* Electronic Parent Signature (Typing your name into the below box indicates your full assumption of risk, authorization, and release of liability in accordance with the above participation agreement)
* Signature for playground consent
Add Another Child
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