AfterSchool 2020 / 2021 Registration
Child #1 Full Name
Child #1 Birthday
mm/dd/yyyy
Child #2 Full name
Child #2 Birthday
mm/dd/yyyy
Parent 1 Full Name
Parent 2 Full Name
Family Home Address
Please record the complete home address.
Parent(s) Telephone Numbers
Please include all work, home, and cell numbers and label accordingly
Parent(s) Email Addresses
Please include all relevant email addresses and label accordingly
How did you find out about KinderHaus?
I am interested in the AfterSchool program for Child #1, on the following days of the week:
Check all that apply
I am interested in the AfterSchool program for Child #2, on the following days of the week:
Check all that apply
Submit
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