Amberlea Kidz Program Registration
To register your child for an Amberlea Kidz program, complete the following form, SCROLL ALL THE WAY TO THE BOTTOM AND CLICK "SUBMIT"

You will receive an automated email from 'amberleachurch@gmail.com' with instructions on how to submit your payment. Note that we must receive your payment within five (5) business days in order to keep your registration.

The red asterisk (*) indicates fields you must complete in order to submit the form

Email address *
Amberlea Program *
Select the program for which you are registering
Your First Name *
Registering parent's first name
Your answer
Your Last Name *
Registering parent's last name
Your answer
Your Phone Number *
Your answer
Your Postal Address
Your answer
Alternative Emergency Contact Name
Your answer
Alternative Emergency Contact Phone
Your answer
Anyone else authorized to pickup your child?
Your answer
Any adults staying for the program?
Your answer
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