KC Registration Monday PM Summer/Fall
CHILD REGISTRATION
Please enter
child
information on this form.
Please note: KidCare for this event is only available for infants through 5th grade.
*
Child
First Name
*
Child
Last Name
*
Child
Birth Date
*
Child
Gender
Female
Male
* Are there any allergies or special needs of which we need to be aware?
* Age/Grade (Monday KidCare - Fall)
Select one
Infant (less than 12 months) [4 left]
1 year olds (12-24 months) [6 left]
2s (24-35 months) [8 left]
Pre-school (3 to 5 years old) [20 left]
School Age (Kindergarten through 5th grade) [33 left]
If your age group is full, select this option to be added to the waitlist
* For which Monday evening class is the PARENT registering?
Select one
Merge
Re|engage - Summer/Fall
ReEngage - Winter/Spring
Re|Engage/Merge Gathering
Women's Bible Study
ManDay Monday
Alpha
* I give my consent for my child to play outside on the Pathway playground.
Select one
Yes
No
* Signature for playground consent
*
Child
Child notes
Add Another Child
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