Kids Unlimited CHILD Registration

Kids Unlimited CHILD Registration - CC Please start with PARENT information at the top of the form and then you will fill out child information.

* First Name

* Last Name

* Are you a member of Central Baptist Church?

* Email

* Mobile Phone

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* Address

* City

* State/Province

* Zip/Postal Code

* Child's Name

* Gender

* Child's Birth Date

* Grade (age group)

* List Child's Allergies

* Is there any educational and/or medical diagnosis of which we need to be aware of? Please explain

Processing registration ...