KG Dragon Hearts Club Registration
2018-2019 Dragon Hearts Club Registration
Kindergarden's Name *
Your answer
Class *
Birthday Month (We will celebrate bdays at meetings) *
Mom's name *
Your answer
Mom's Cell Phone # *
Your answer
Parents Email *
Your answer
Dad's name *
Your answer
Dad's Cell Phone # *
Your answer
Home address *
Your answer
Any Allergies or Health Concerns *
Your answer
Child's Dr's name & phone number *
Your answer
Emergency Contact Info (Name & Phone Number) *
Your answer
Child may be picked up by: (please list) *
Your answer
KG Helpers
Permission for Child to be Photographed: *
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