Kids Club Enrollment--KEARNEY ELEMENTARY
The email address at the top of this form is where your response receipt will be sent if you choose that option at the end.
Email address *
Child's First and Last Name *
Your answer
Sex *
Birthdate (MM/DD/YYYY) *
Your answer
School Name *
Grade Level *
Street Address *
Your answer
City, State & Zip Code *
Your answer
Home Phone *
Your answer
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