Kidz Klub Registration Kidz Klub Registration Child's Name(Required) First Last Gender(Required) Male Female Prefer Not To Answer Age(Required)Birthdate(Required) MM slash DD slash YYYY Grade(Required) Preschool Kindergarten First Second Third Fourth Fifth Transportation Needed(Required) Yes No Allergies Parent/ Guardian Name(Required) First Last Address(Required) Street Address City State ZIP / Postal Code Phone(Required)Email Child #2 Gender Male Female Prefer Not To Answer Age Birthdate MM slash DD slash YYYY Grade Preschool Kindergarten First Second Third Fourth Fifth Allergies Child #3 Gender Male Female Prefer Not To Answer Age Birthdate MM slash DD slash YYYY Grade Preschool Kindergarten First Second Third Fourth Fifth Allergies Child #4 Gender Male Female Prefer Not To Answer Age Birthdate MM slash DD slash YYYY Grade Preschool Kindergarten First Second Third Fourth Fifth Allergies
