WELCOME TO
COMMUNITY KIDS

Guardian's First Name

Guardian's Last Name

We desire to partner with you to ensure a safe and caring environment for your child(ren). If, during service, you're needed to return to Community Kids we will be texting you at this number. Please be sure to keep your phone accessible but silenced during service.

Phone Number

Email

How many children are you checking into Community Kids?

First Child's First Name

First Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?

Second Child's First Name

Second Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?

Third Child's First Name

Third Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?

Fourth Child's First Name

Fourth Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?

Fifth Child's First Name

Fifth Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?

Sixth Child's First Name

Sixth Child's Last Name

Birthdate

Child's Age

Current Grade

Any Allergies or Other Information We Should Know?