Kennesaw Kids Registration Form

Kennesaw Kids Registration Form

Fill out the form carefully for registration
Child's Name *

First Name Middle Name Last Name
Birth Date

Month Day Year
Grade Level *

Pre-K Kindergarten 1st 2nd 3rd 4th 5th
Gender *
Parent/Guardian 1 Full Name *

First Name Last Name
Parent/Guardian 1 Email *
example@example.com
Parent/Guardian 1 Phone *
Please enter a valid phone number.
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian 2 Full Name

First Name Last Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone
Please enter a valid phone number.
Emergency Contact Name *

First Name Last Name
Emergency Contact Relation to Child *
Emergency Contact Phone *
Please enter a valid phone number.
Emergency Contact Email *
example@example.com
List any allergies/medical conditions/special needs
I give permission for Kennesaw UMC to use photos of my child’s ministry involvement for promotional use, as well as website placement. (If yes: enter adult's name | yes | date. If no: enter adult's name | no | date. *
If you have additional children please click on "NEXT"

If you have additional children please click on "NEXT"