Shine Kids Registration Form
Parents, please completely fill out the information below to register your child (or children) for Shine. If you're a returning family and everything is the same as last year, you do not need to re-register. But, if you have a new child or any other information needs updated, please re-register. Shine is for kids 30 months through 5th Grade. Classes begin at 5:00pm on Sunday, September 10th.
Sign in to Google to save your progress. Learn more
Parent's First & Last Names *
John and Jane Doe
Address *
123 N Main St, Ankeny, 50021
Cell Phone Number *
(555) 123-4567
Email Address *
This is the email address we will send a weekly update to.
First Child's Name *
First Child's Birthday *
01/25/2011
First Child's Grade/Class *
Grade for 2016-2017
Required
First Child's Allergies/Special Needs?
Second Child's Name
Second Child's Birthday
01/25/2011
Second Child's Grade/Class
Grade for 2017-2018
Second Child's Allergies/Special Needs?
Third Child's Name
Third Child's Birthday
01/25/2011
Third Child's Grade/Class
Grade for 2017-2018
Third Child's Allergies/Special Needs?
Fourth Child's Name
Fourth Child's Birthday
01/25/2011
Fourth Child's Grade/Class
Grade for 2017-2018
Fourth Child's Allergies/Special Needs?
Fifth Child's Name
Fifth Child's Birthday
01/25/2011
Fifth Child's Grade/Class
Grade for 2017-2018
Fifth Child's Allergies/Special Needs?
Additional Information
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms