Kool Kidz Read Membership Application
Welcome to the KOOLEST Book Club!
For new members joining Kool Kidz Read, the below information allows us to collect essential information, ensuring a smooth and engaging experience. Happy Reading and Leading!
Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Name
*
First Name
Last Name
Child's Age
*
Child's Current Grade
*
Child's Reading Level
*
Please Select
Beginner
Intermediate
Advanced
Not Sure
Membership Information
Membership Type
*
Please Select
Monthly Membership ($25 per month)
Annual Membership ($250 per year)
Reading Preferences - What types of books interest your child? (Check all that apply)
*
Picture Books
Chapter Books
Graphic Novels
Would your child like to participate in our virtual or in-person read-aloud sessions?
*
Virtual
In-Person
Would your child like to submit book reviews or creative projects to be featured on our website or social media?
*
Yes
No
Would you like to volunteer or contribute to Kool Kidz Read programs/events?
*
Yes
No
Permissions & Agreement
Photo & Video Consent: Do you give permission for Kool Kidz Read to share photos/videos of your child engaging in club activities on our website/social media?
*
Yes
No
Acknowledgment
I understand that membership payments are non-refundable.I agree to notify Kool Kidz Read via email (hello@koolkidzread.com) at least 60 days in advance for membership cancellation requests.
Signature
*
My Products
*
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Kool Kidz Read Monthly Membership
✅ Monthly Membership for one – $25/month (Non-refundable) Join Kool Kidz Read for $25/month! Payments auto-renew, and a 45-day cancellation notice is required via hello@koolkidzread.com.
$
25.00
Quantity
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Kool Kidz Read Annual Membership
✅ Annual Membership for one – $250/year (Non-refundable) Enjoy a full year of Kool Kidz Read for $250! One-time payment, no refunds. Questions? Email hello@koolkidzread.com.
$
250.00
Quantity
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Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
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