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Complete this form no later than Friday, May 17th, 2024
We appreciate your desire to join our 2024 Kids Club Summer Program!
*Submitting a Registration Form does not guarantee a spot.*
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* Indicates required question
Parent Name
*
Your answer
Child Name (First / Last)
*
Your answer
Address
*
Your answer
City, Zip Code
*
Your answer
Phone Number (Home)
*
Your answer
Phone Number (Work)
*
Your answer
Email Address
*
Your answer
Child Date of Birth (M/D/Y)
*
MM
/
DD
/
YYYY
Start Date (M/D/Y)(Earliest Availability is 6/10/24)
*
MM
/
DD
/
YYYY
Days Attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
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