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Kids Connexion 2022-2023 Registration
Wednesdays after school until 5:00pm (or 3:00pm on Early Release Days)
beginning Aug. 17, 2022
Frederick First United Methodist Church
301. E. Grand Ave (12th & Grand)
335-7505 or
fredfumc@pldi.net
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* Indicates required question
Email
*
Your email
Child's Name (First & Last)
*
Your answer
Child's Grade
*
Pre-K
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Parents'/Guardians' Name(s) (First & Last)
*
Your answer
Phone numbers
*
Your answer
Address
*
Your answer
Emergency contact (name & phone)
*
Your answer
Does your child need transportation to the church after school?
*
Yes, I need my child to be walked over from Prather Brown.
Yes, I need my child to be given a ride from Frederick Elementary.
No, my child will get there another way.
How will your child get home?
*
My child will be picked up.
My child will need a ride home.
My child will walk home.
It might change from week to week.
Who has permission to pick up your child? (Please list more than one name.)
*
Your answer
Food or other allergies?
Your answer
Anything else we need to know?
Your answer
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