Poem by Henry Wadsworth Longfellow

Online Sign-up - Spring Classes

Please fill in the form below. If you wish to print and mail/fax the form click here for the printable version. Required fields are denoted by the (*) symbol.

Which Session are YouSigning up For? *
Choose a class *	Choose which days your child will attend class* * Note there is an overlap in the grades
Child's Information
Child’s Name *
Gender *
Date of Birth *
Grade Level Completed *
Tee Shirt Size (Youth Sizes) *
Parent's Information
Parent's Name *
Parent’s E-Mail Address *
Sibling's Name (if applicable)
Home Phone *
Work Phone
Cell Phone
Address
Street Address *
City *
State *
Zip *
Caregiver Orientation
Adult Caregiver attending the Orientation *
Relationship of Caregiver to Child *
Authorization and Medical Information
The fee for the class is $150.00. A $25.00 discount for multiple children enrolled in the same class Session also applies. I agree to pay $ for the class and understand the fees paid herewith are non-refundable. I, the parent/legal guardian of the above name child, give Kinder Kids the authority to seek necessary medical attention in the event of injury to my child, should I be unreachable at such time. I also give Kinder Kids permission to use any photos obtained from classes for promotional purposes. I further agree not to hold Kinder Kids or any of its employees liable at any time.
My child has the following food allergies: (if none, so state) *
My child’s physician is *
Physician’s Phone Number: *
Special needs Kinder Kids should consider: (if none, so state) *
Electronic Signature of Parent or Guardian (type in your full name) *	Date
For payment, I would like to: *