• Palmetto Kids Family Registration

  • Primary Parent/Guardian

    If we need to contact a parent for any reason, this is who we will contact first.
  • Format: (000) 000-0000.
  • Membership Status*

  • Next Parent/Guardian

    If we cannot reach the primary point of contact, this is who we'll try to contact next.
  • Format: (000) 000-0000.
  • Membership Status*

  • Children

    Any children under 18 in your household
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • Do you have another child to add?*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • Do you have another child to add?*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • Do you have another child to add?*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*
  • Do you have another child to add?*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Gender*

  • Release

    Please read the below release and respond accordingly.
  • I agree that as a participant, my child may be photographed or videotaped during normal activities and these images may be used in church related promotions. I also understand that my child's allergies will be made available to his/her teacher(s) and will be listed on his/her nametag.
  • Should be Empty: