Palm Beach Kids Registration

1
Parent or Guardian Information
First Name
Last Name
Please enter your phone
Please enter your email
2
How many children will be joining the Kids Program?* This field is required.
Please Select
Please Select
1
2
3
4
5
3
Child #1
Name as you would like it to appear on their nametag
Age of Child at Time of Event
Please Select
Please Select
Male
Female
Gender
Please list any special needs like physical limitations, behavior challenges, allergies, gluten-free, etc
4
Child #2
Name as you would like it to appear on their nametag
Age of Child at Time of Event
Please Select
Please Select
Male
Female
Gender
Please list any special needs like physical limitations, behavior challenges, allergies, gluten-free, etc
5
Child #3
Name as you would like it to appear on their nametag
Age of Child at Time of Event
Please Select
Please Select
Male
Female
Gender
Please list any special needs like physical limitations, behavior challenges, allergies, gluten-free, etc
6
Child #4
Name as you would like it to appear on their nametag
Age of Child at Time of Event
Please Select
Please Select
Male
Female
Gender
Please list any special needs like physical limitations, behavior challenges, allergies, gluten-free, etc
7
Child #5
Name as you would like it to appear on their nametag
Age of Child at Time of Event
Please Select
Please Select
Male
Female
Gender
Please list any special needs like physical limitations, behavior challenges, allergies, gluten-free, etc
8
Is there anything else you would like our team to know as we prepare this time for your child(ren)?
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Ok
Ok
Should be Empty: