Kiker 2021-2022 Voyager Registration Student Information
One child's information per form - if more than one child is in the program you will need to submit another form.
Email address *
Student's legal LAST name *
Student's legal FIRST name *
Student's gender
Clear selection
Student's grade level for school year 2021-2022 *
Health Information
List any medical conditions, such as, heart disease, diabetes, epilepsy, severe allergies, eye or ear problems, any chronic conditions or any other conditions of which the Voyager Program should be aware. Children with Special Needs If your child has special needs, please discuss those needs with the staff. The staff will assess those needs and make reasonable efforts to accommodate your child. Due to staffing limitations, the program may not be able to accommodate children who need one-on-one care.
Food Allergies *
List any food allergies your child has or answer none.
Home Address *
Best Phone# *
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