Child Registration Form
Please fill out this form and click submit.
Please fill out the registration form below for each child. This will ensure your child is able to be checked in and out in a safe manner. Your child's safety is one of our main concerns.
Child's First and Last Name
*
Child's Gender
*
Please select one option.
Male
Female
Parent/Guardian 1 First and Last Name
*
Parent/Guardian 2 First and Last Name
Parent/Guardian 1 Phone
*
Parent/Guardian 2 Phone
Parent/Guardian Email
*
This address will receive a confirmation email
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Allergies
Please select all that apply.
No
Yes
Submit
Description
Please fill out this form and click submit.
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