Kingdom Kidz Registration 2020
Please fill in the form below.
Name of Child
*
First Name
Last Name
Grade of Child
*
K-1, 2-3, 4-5
Age
Birthdate
Child's Gender
Male
Female
Name of Parent/Guardian
*
First Name
Last Name
Address
Email Address
Parent/Guardian Phone Numbers
*
-
Home
Cell
Name of Additional Emergency Contact
*
First Name
Last Name
Relation to Child
Phone Number of Additional Emergency Contact
*
-
Home
Cell
Allergies, Medications, Other Medical Alerts or Concerns
*
Submit
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