Kidz-N-Play

Registration Type (Please Choose One)

Child Adult/Teen

First & Last Name

Primary Contact Email

This address will receive a confirmation email

Primary Contact Phone #

A. Continue for Child Registration Only

If you are registering a child for Kidz-N-Play please complete this section. PLEASE NOTE: This is for children currently in Kindergarten - 5th Grade. We will not be able to accommodate children younger than this. For everyone's safety, please only register children currently in Kindergarten through 5th Grade.
Anything in this section not filled out will be marked as an incomplete registration. Please make sure all fields are filled out.

If you are registering as a volunteer (Crew Member), go to Section B

Grade Level

Child's Birthdate

Child's Gender Female Male

Medical Notes (Please let us know of any allergies or sensitivities)

Emergency Contact Name First & Last

Emergency Contact Phone

Request a Friend

You can request a friend to be put on the same team as your child. We will try our best to accommodate. (Please limit to 1 friend) Siblings will be put on the same color team.

Request a Friend Name

Pick Up Permission
Please list any additional adults that have permission to pick up your child.

If you are picking up your child each day, you can leave this blank.

Name(s)

I attend Alsbury Baptist Church

Yes No

If no, do you attend church somewhere? Yes No

Would you like to receive future notifications about children events at Alsbury? Yes No Option

B. Continue for Crew Registration Only

If you are registering to volunteer for Kidz-N-Play, please complete this section

What position are you registering for?

Hours I'm available:

Days Available Every Day Monday Tuesday Wednesday Thursday

Kidz-N-Play

Description

Please Fix the Following