Discovery Co-op Kids Club Database Update
We’re updating our Kids Club database! Please fill out this short form to ensure your child continues to receive all the benefits of being a Kids Club member. Please fill out one form per child.
Child's Name
*
First Name
Last Name
Child's Birthday
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent's Discovery Co-op Member Number
*
Parent's Email
*
example@example.com
If you elect to opt-in, your email address will be used to contact you regarding Co-op Kids Club membership activities. The Co-op respects your privacy and will administer the personal information that you provide to it by way of this Kids Club Application in accordance with its privacy policies and related practices. The personal information that you provide to the Co-op is being collected and may be used for one or more of the following purposes: Address may be used to send birthday cards and other communications related to Kids Club activities. Phone number may be used for general contact purposes related to this application or related to Kids Club activities. Birthdate will be used to confirm eligibility for Kids Club and may be used to send birthday cards.
*
I consent for the use of my child's personal information to join Co-op's Kids Club and for my child to participate in Co-op Kids Club activities
Parent's Name
*
First Name
Last Name
Submit
Should be Empty: