Kidcrest Pre-registration

Please fill out this form completely. We will then register your family and take pictures to fulfill our safety and security procedures.

Location *
Father/Stepfather Name
Father/Stepfather Name
Mother/Stepmother Name
Mother/Stepmother Name
Mailing Address *
Mailing Address
Phone (Required) *
Phone (Required)
We may need to contact you after the weekend about your child
Children Infant-5th grade to attend Kidcrest:
Child 1
Name
Name
Gender
Birthdate
Birthdate
Child 2
Name
Name
Gender
Birthdate
Birthdate
Child 3
Name
Name
Gender
Birthdate
Birthdate
Child 4
Name
Name
Gender
Birthdate
Birthdate
We're dedicated to keeping your children safe
Special Circumstances
Is there a need for any of the following ALERT STICKERS for any of these children?
OTHER drop off/pick up person
Name
Name
Address
Address
Phone
Phone