SMART CARD Kids

1

Here's The LayoutClick Next To Continue.

2

Profile PictureBest Results Use A Picture With The Parent & Child

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

4

Childs First Name(Optional)

5

Primary Parent Name* This field is required.

First Name

Last Name Initial

6

Relationship* This field is required.(Ex. Mom, Dad, Grandparent, Guardian...)

7

Primary Phone Number* This field is required.

Please enter a valid phone number.

8

Would You Like To Add Another Parent?

YESNO

9

Second Parent's Name

First Name

Last Name Initial

10

Relationship(Ex. Mom, Dad, Grandparent, Guardian...)

11

Second Phone Number

Please enter a valid phone number.

12

Would You Like To Add Any Medical Emergency Information?

YESNO

13

Medical Emergency Information(Ex. Allergic to Peanuts, Bee Stings - Use EpiPen In His Backpack.)

14

Would You Like A Recovery Code?Make a Safety Code that only you would know by heart. They will ask you to know this code when picking up your child.

YESNO

15

Code:Make Sure You Remember The Code You Put In. (Ex. Bug123, Bunny Love...)

16

Would You Like To Leave A Message Or Instructions?

YESNO

17

Message Or Instructions

18

Terms and Conditions* This field is required.By Clicking The Check Mark You Have Read Our Terms & Conditions.