Registration Form

Registration Form
We believe every child can know Jesus personally and have a relationship with Him- they just need the opportunity!

Kidz Klub is part a multi-faceted, faith-based ministry based in the heart of Hollywood, by The Oasis of Hollywood, Kidz Klub is for 1st-6th graders. We are passionate about reaching & serving the next generation & their families by meeting spiritual and practical needs.

For more information about Kidz Klub please visit https://oasisofhollywood.org/kidz-klub/

We provide free pickups at Grant Elementary from 2:20-2:45, at the Harold Way entrance!

We provide free dropoffs within the Hollywood area!
Date/Time: Wednesday's, 3:30-5:00PM
Address: 4150 Monroe St. LA, CA 90029

Any further questions or concerns?
Please contact Oasis directly (323) 469-3027 or
Our Kidz Klub Director Thaddeus Sanchez
Cell: (323) 506-2835
Email: thaddeus@oasisofhollywood.org
Parent / Guardian Email*
example@example.com
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Child's Grade*

Kinder1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade
Child's School*
How will your child be getting to Kidz Klub?*

Dropped off by parent/guardianPicked up at SchoolLocation
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does Your Child Have Any Allergies*
Parent / Guardian Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Consent and Release from Liability:

I’ve given permission to my child to attend Kidz Klub. I understand that my child can either get picked up for Kidz Klub at Grant Elementary, or dropped off by a parent/guardian. I understand that Kidz Klub will provide drop offs in the Hollywood area only. In case of emergency, I hereby authorize Kidz Klub to contact emergency personnel and release pertinent information. I also agree to release Kidz Klub and its personnel, agents, and volunteers from any liability resulting from and/or in connection to this after school activity.
Signature*

Clear
Emergency Contact
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relation to Child*
Is there anything else we need to know or be aware of?*
Should be Empty:

Registration Form

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