Kenosha Police Summer Safety Program
Use this form to register for the Kenosha Police Department's Officer Friendly Summer Safety Program
Select Time Slot *
Child's Name (First & Last) *
Your answer
Address *
Your answer
Zip Code *
Your answer
Phone # *
Your answer
Email Address *
Your answer
Allergies/ Special Needs *
Your answer
Age at time of class *
Required
Emergency Contact *
Your answer
Emergency Contact Phone # *
Your answer
Parent Completing Form *
Your answer
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