Friends Club Registration Form
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Full Name of Child *
Gender *
Child's Age *
Child's Grade in School
Child's Date of Birth *
Does the child have any special needs?
Does the child have any known allergies?
Is the child on any medications we should be aware of?
Residential Parent or Guardian *
Home Address *
City *
State *
Zip Code *
Primary Phone Number *
Cell Phone Number(s) of Parent or Guardian
E-Mail Address (Optional)
Alternate Contact in Case of an Emergency
Home Address of Alternate Contact
Phone Number(s) of Alternate Contact
Would you like to receive text messages to update you on club events and cancellations?
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Phone number to use for text messages
May we photograph your child for Friends Club presentations or promotion? *
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