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?
Select one
Yes
No
* Email
* Mobile Phone
* Address
* City
* State/Province
* Zip/Postal Code
* Child's Name
* Gender
Select one
Male
Female
* Child's Birth Date
* Grade (age group)
Select one
3 year old
4 year old
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
* List Child's Allergies
* Is there any educational and/or medical diagnosis of which we need to be aware of? Please explain
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