PORT CITY KIDS
CLASS REGISTRATION
* Required
PLEASE SELECT ONE
*
WEDNESDAY NIGHT
SUNDAY SCHOOL
Required
DATE
MM
/
DD
/
YYYY
NAME OF CHILD #1
*
Your answer
CLASS ROOM
*
Wednesday NIGHT
PRESCHOOL/KINDER
Elementary
NAME OF CHILD #2
Your answer
CLASS ROOM
PRESCHOOL/KINDER
ELEMENTARY
Wednesday NIGHT
Clear selection
NAME OF CHILD #3
Your answer
CLASS ROOM
*
PRESCHOOL/KINDER
ELEMENTARY
WEDNESDAY NIGHT
NAME OF PARENT(GUARDIAN)
*
Your answer
PARENT(GUARDIAN) CONTACT NUMBER
*
Your answer
ANY SPECIAL NEEDS OR ALLEGERIES for any CHILD? PLEASE DISCLOSE *
*
Your answer
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