K4T Registration Form
Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Relationship
*
Relationship to the Child/Children (ex. mother, father, grandparent, stepfather, etc.)
Email
*
example@example.com
Phone
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is there another legal guardian?
Yes
No
Parent/Guardian Name
*
First Name
Last Name
Relationship
*
Relationship to the Child/Children (ex. mother, father, grandparent, stepfather, etc.)
Email
*
example@example.com
Home Phone
-
Area Code
Phone Number
Cell Phone
*
-
Area Code
Phone Number
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child/Children Information
Total Kids
1
2
3
4
5
6
7
8
9
10
How many children are you registering for Kids4Truth?
Student Info
*
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Grade
Preschool-Kindergarten
1st-2nd Grade
3rd-4th Grade
5th-6th Grade
Medical Comments
Please list below any allergies or medical concerns that you would like us to know about your child/children.
Kids4Truth- TruthBooks
Each child needs 1 Truthbook per year, $8 per book (capped at $24 for 3+ children)
Total Cost Calculated
Form of Payment
*
Credit
Cash/Check
K4T-TruthBooks
prev
next
( X )
USD
Total to be paid by Credit Card
Total Cost
Total to be paid by Cash/Check in person
Submit
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