Kids First for Kids! Registration Form

Kids First For Kids! Remote

First provide enrollment details, then select a session, and finally, submit payment. Any questions, contact Kids First at info@kidsfirstcenter.org or call (207) 761-2709.
Registering Parent/Guardian Full Name *

First Name Last Name
Registering parent's gender

Male Female Other
Registering parent's address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Maine County of Residence *
County
Registering parent's email *
Confirm email address *
example@example.com
Phone number where we can leave a message if necessary *

Area Code Phone Number
In all cases where parents share parental rights and responsiblities and/or decision making, both parents MUST consent to thier children participating in Kids First for Kids! Remote. The Kids First Center will contact your child's other parent to confirm consent. Please provide contact information for your child's other parent.

If you have a court order that allows you to make the decision to enroll your child(ren) in this program without the consent of the other parent, please upload a copy of that order at below. If no such order is provided, the Kids First Center will assume that all legal parents must provide written consent to enroll.
Upload order granting sole parental rights or sole decision making, if applicable.

Browse Files

Cancel of
Name of children's other parent/guardian. If your child has more than one other legal parent/guardian, please contact the Kids First Center by email or by phone.

First Name Last Name
Other Parent's Gender

Male Female Other
Other Parent's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Other Parent's Maine County of Residence *
County
Other Parent's Email *
example@example.com
Confirm Other Parent's Email *
example@example.com
Phone number where we can leave a message for other parent, if necessary *

Area Code Phone Number
Full name, preferred name or nickname, preferred pronouns, and date of dirth of child(ren) to be enrolled (Note: your child should be in either the 4th or 5th grade at the time the class first meets) *
Child's current grade in school *
Please let us know if we should be aware of any special needs that your child(ren) may have that could impact participation in this online group.
How did you hear about the Kids First for Kids! Remote program? (check all that apply) *

I was referred by a Judge or Family Law Magistrate I was referred by an attorney I was referred by a guardian ad litem I was referred by a mental health provider/counselor/therapist I was referred by a health care provider-MaineHealth network I was referred by a health care provider-InterMed network I was referred by a health care provider-Martin's Point Health Care network I was referred by a health care provider-other I was referred by a domestic violence prevention agency I was referred by a police officer/department I was referred by someone at my child(ren)'s school I learned about Kids First from a friend I learned about Kids First from your website/internet search I learned about Kids First from the Aunt Bertha search engine
Please select the session you want to register for:
If you require financial assistance, please skip the "select fee" and "credit card" questions and contact the Kids First Center at info@kidsfirstcenter.org or (207) 761-2709 for assistance in enrolling.

Select fee (choose one)

Kids First for Kids! Remote-One Child $ 75.00

Kids First for Kids! Remote-Two Siblings $ 120.00

Kids First for Kids! Remote-Three Siblings $ 180.00

Kids First for Kids! Remote-Four Siblings $ 240.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

By my signature below, I hereby consent to the child(ren) identified in this enrollment form to participate in the Kids First for Kids! Remote group.

Please use mouse, digital pen, or finger to complete signature
Signature *

Clear
Thank you for enrolling in the Kids First for Kids! Remote program. After all necessary consents are signed, you will be receiving additional information about the Kids First for Kids! Remote Kit and on how your child(ren) can join the online group.
Should be Empty:

Kids First For Kids! Remote