Gateway 2017 Child Registration Form
child registration form
Please enter your Gateway Ticket Number
Your answer
Please enter your full legal name
Your answer
Please enter any other name you will be using at the event or else enter N/A
Your answer
Please enter your child's date of birth
MM
/
DD
/
YYYY
Please enter child's ticket number
If child is under 12 skip this and go to the next question
Your answer
Please Enter your child's full legal name
Your answer
Please enter any other name your child may be using at the event or enter N/A
Your answer
Enter emergency contact information
Your answer
Please list any other parents/guardians who will be responsible for watching your child.
Your answer
Enter your email address
Your answer
Does your child have any serious allergies or other health concerns that you would like to inform us of in case of an emergency? *
Your answer
Any additional information you would like to share?
Your answer
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