J.A.M.ers and Kids Connection Registration Form 2019-2020
Email address *
Child's Last Name: *
Your answer
Child's First Name: *
Your answer
Mailing Address: *
Your answer
Postal Code: *
Your answer
Primary Phone Number: *
Your answer
Name of Parent(s)/Guardian(s): *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
2019-2020 School Grade: *
Does your child have any allergies or medical conditions we should be aware of: *
If your answer is "yes" to the above question, please provide us with details:
Your answer
A copy of your responses will be emailed to the address you provided.
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