FPC Kids' Klub Registration 2024-25

Child's Name

Grade, School & Teacher

Birthdate

Parent/Guardian 1 Name

Address

This address will receive a confirmation email

Best Contact Phone

Parent/Guardian 2 Name

Address

Best Contact Phone

Emergency Contact if Parent/Guardian not available (Name & Relationship to Child)

Phone

Names of those with permission to pick up your child

Does your child have any allergies? If so, what?

Is there anything else you would like us to know about your child?

LONGFELLOW ONLY--Pick up after school? Yes No

PHOTO RELEASE--Do we have permission to post photos of your child on our church Facebook & Instagram pages, or on our website (no names attached)?

Yes No

Description

Thanks for giving us all the information we need for your child to participate in Kids' Klub this year. Please fill out this form and click submit.