Wed Night Kids Pre-Registration Form

Please fill out this form and click submit.

Redeemer's Kids kicked off on September 2nd at 7:00pm on Redeemer's Church front lawn.

Please pre-register so that we can create groups of similar aged kids and still maintain a 5:1 kid to leader ratio. (Note: Space is limited and offered to 1st-5th grade only.)

Parent/Guardian: Tell us about you!

Parent/Guardian Name

*

Parent/Guardian Email

*

This address will receive a confirmation email

Parent/Guardian Phone

*

Mailing Address (street/city/zip)

*

Relation to child(ren)

*

Please select one option.

parent grandparent aunt/uncle other

KIDS: Tell us about your kids!

Child #1 (First & Last Name)

*

Gender

*

Please select all that apply.

Male Female

Date of birth (mm/dd/yyyy)

*

Grade

*

Please select one option.

1st 2nd 3rd 4th 5th

List any allergies or type "none"

*

Child #2 (First & Last Name)

Gender

Please select all that apply.

Male Female

Date of birth (mm/dd/yyyy)

Grade

Please select one option.

1st 2nd 3rd 4th 5th

List any allergies or type "none"

Child #3 (First & Last Name)

Gender

Please select all that apply.

Male Female

Date of birth (mm/dd/yyyy)

Grade

Please select one option.

1st 2nd 3rd 4th 5th

List any allergies or type "none"

Description

Please fill out this form and click submit.

Please Fix the Following

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