M.O. Town Kids Registration
Email address *
Parent/ Guardian Information
Please fill out the information below for at least one parent or guardian
Parent/Guardian Name *
Your answer
Address *
Your answer
Cell Phone Number *
Your answer
Parent/Guardian #2 (optional)
Your answer
Address (Optional)
Your answer
Cell (optional)
Your answer
Child's information
Please fill out the information below for each child ages 1 through 3rd grade.
Child #1 *
Your answer
Birth-date *
MM
/
DD
/
YYYY
Grade (if applicable)
Medical Needs
Your answer
Anything else we should be aware of
Your answer
Child #2
Your answer
Birthday
MM
/
DD
/
YYYY
Grade (if applicable)
Medical needs
Your answer
Any other information we should be aware of:
Your answer
Child #3
Your answer
Birthday
MM
/
DD
/
YYYY
Grade (if applicable)
Medical Needs
Your answer
Any other information we should be aware of:
Your answer
Child #4
Your answer
Birthday
MM
/
DD
/
YYYY
Grade (if applicable)
Medical Needs
Your answer
Any other information we should know
Your answer
Submit
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