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KidsRock Registration 2023-2024
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* Indicates required question
Email
*
Your email
Child's Name (please include first and last name)
*
Your answer
Address
*
Your answer
Parent/Guardian Names
*
Your answer
Phone Numbers for Parents/Guardians (please label)
*
Your answer
Grade Entering in Fall 2023
*
young child/at home with parent
preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Child's Birthday
*
MM
/
DD
/
YYYY
Please share with us any special interests or needs your child might have
*
Your answer
Please list any dietary restrictions and allergies
*
Your answer
For parents of infants and toddlers: Is it okay to diaper or take your child to the bathroom if you are unavailable? (School-age children will be escorted to the bathroom by a volunteer who will stand outside the shut bathroom door)
Yes
No
Other:
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I give Granite City Church permission to use photos of my child on the church's social media accounts (facebook, instagram, youtube) with the understanding that his/her name will not be used.
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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