Kingdom Kidz 2022/2023
Please fill in the form below.
Name of Child
none, pre, k, 1-6
use numbers - no dashes 01012021
Name of Parent/Guardian
Parent/Guardian Phone Numbers
Name of Additional Emergency Contact
Relation to Child
Phone Number of Additional Emergency Contact
Allergies, Medications, Other Medical Alerts or Concerns
Mark if you DO NOT want your child's photo to be used on social media such as our Facebook page or website.
I do not want my child's photo used.
Should be Empty:
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