WAITLIST- KIDS Club Registration 2022-2023
Christ The King School
Parents Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Moms Cell Phone
*
Please enter a valid phone number.
Moms Email
*
example@example.com
Dads Cell Phone
*
Please enter a valid phone number.
Dads Email
*
example@example.com
Emergency Contact
*
First Name
Last Name
Emergency Number
*
Please enter a valid phone number.
Relationship to Child
*
1st Student Name
*
First Name
Last Name
Grade Attending in 22-23
*
Allergies
*
2nd Student Name
First Name
Last Name
Grade Attending in 22-23
*
Allergies
*
3rd Student Name
First Name
Last Name
Grade Attending in 22-23
*
Allergies
*
Type of Plan
*
5 Day
3 Day
Days Attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Tuition to be paid through
*
FACTS/ 8 Month Plan
Check/ Semester
Check/ Monthly
Signature
*
By signing this form I agree that my child/children will be attending KIDS CLUB
Submit
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