Kidz Club Sign-Up
Childcare for parents in Wednesday night groups ONLY. Ages 6 weeks - 4th grade.
Child(s) Name
*
First Name
Last Name
Child(s) Age
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Backup Parent/Guardian Name
*
First Name
Last Name
Backup Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergies or Special Concerns for the Children
What is your small group leader’s name?
Payment for each child is $60. This is to be paid on the first night of group when you take them to Kidz Club. Your payment options are cash or check. Check may be made out to Overflow Church with Kidz Club on the memo line.
Submit Registration
Should be Empty: