St. John Kids of the Kingdom Child Registration
This is a registration form for children attending St. John Lutheran Church Kids of the Kingdom after school program for kids P-5th grade. We meet the first Wednesday each month (Oct-May) from 2:00 - 4:00 p.m. Please complete and submit a registration form for your child/children. Space is limited. THANK YOU!
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Email *
Name of Child(ren) / Age / School Grade / Date of Birth *
Does your child have any food allergies we should be aware of? Please list.  *
Parent Name / Phone # / Email / Mailing Address *
Emergency Contact Name / Phone # in the event you cannot be reached *
How do you prefer to be contacted in non-emergency situations (reminders, etc.)? *

The following people HAVE permission to pick-up the child named below from St. John Kids of the Kingdom events. 

Is your child allowed to walk home after Kids of the Kingdom without adult supervision?
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A copy of your responses will be emailed to the address you provided.
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