KidzRock Child Registration 2017
KidzRock runs September 10th through May 20th from 9:30 am - 10:30 am . The following Sundays we do not meet: Nov. 26th, Dec. 24th, Dec. 31st, March 11th, March 18th and April 1st.

WOW (Kindergarten - 4th grade) and JUMP56 (5th and 6th grade) run on Wednesdays from 6:00pm to 7:15pm. Sept 13th through Nov.15th and Jan. 10th through April 25th.

3 year olds MUST TURN 3 BY September 15, 2017.

Questions or Concerns:

Please contact kidz@naz.org or call NAZ at (319) 266-7589.

Email address *
Parent/Guardian First and Last Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Mailing Address *
Your answer
Zip Code *
Your answer
Secondary Parent/Guardian Email Address
Your answer
Secondary Parent/Guardian Phone Number
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Gender? *
Required
Child's Mailing Address, if different from Parent/Guardian Address
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Medical Conditions and/or Behavioral Concerns (Including Allergies) *
If your child has no known medical conditions or behavioral concerns, please type none.
Your answer
Child's Grade *
Child's Current School *
Your answer
My child will be attending *
Do you have a "KidCheck" account? *
Required
What is the phone number associated with the KidCheck account? *
Your answer
Photo/Video Release: Photographic and Video Recording devices will be used at this event and the images captured could be used for publicity and/or historical purposes in a print or web-based media outlet. *
Required
Additional Notes:
Your answer
A copy of your responses will be emailed to the address you provided.
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