JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Kidsrock Registration
Contact:
kidsrock@highrockbrookline.org
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of caregiver #1
*
Your answer
Cell phone contact for caregiver #1
*
Your answer
Email contact for caregiver #1
*
Your answer
Name of caregiver #2 (if applicable)
Your answer
Cell phone contact for caregiver #2 (if applicable)
Your answer
Email contact for caregiver #2 (if applicable)
Your answer
Name and age for Child #1
*
Your answer
Birthday for Child #1
*
MM
/
DD
/
YYYY
Name and age for Child #2 (if applicable)
Your answer
Birthday for Child #2 (if applicable)
MM
/
DD
/
YYYY
Name and age for Child #3 (if applicable)
Your answer
Birthday for Child #3 (if applicable)
MM
/
DD
/
YYYY
Name and age for Child #4 (if applicable)
Your answer
Birthday for Child #4 (if applicable)
MM
/
DD
/
YYYY
Allergies of child(ren), if any
*
Your answer
By checking the box below, I understand that HR Brookline volunteers will contact me should they identify a situation in which a caregiver's presence is needed.
*
Yes
Required
Would a caregiver be interested in being a Kidsrock teacher? You could be in your child's class, or the other class.
*
Yes, please sign me up!
Not at this time
Already signed up
Anything else that you would like us to be aware of?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
