Parkside Kids Family Registration
Please fill out this form and click submit.
We're excited to have your family join us at Parkside Church! In order to better serve you, please provide us with some information about your family. We look forward to getting to know you and your family better!
Your Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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Please Complete for Each Family Member
Secondary Adult Name
Email
Phone
First Child's Name
Birthdate (month/day/year)
Grade
Medical Notes (Including Allergies) or Other Pertinent Information You'd Like Us to Know
If your child is in the Nursery, please let us know if:
*
Please select one option.
You'd like to be called to change your child's diaper.
You'd like nursery staff to change your child's diaper.
Your child is potty training.
Second Child's Name
Birthdate (month/day/year)
Grade
Medical Notes (Including Allergies) or Other Pertinent Information You'd Like Us to Know
If your child is in the Nursery, please let us know if:
Please select one option.
You'd like to be called to change your child's diaper.
You'd like nursery staff to change your child's diaper.
Your child is potty training.
Third Child's Name
Birthdate (month/day/year)
Grade
Medical Notes (Including Allergies) or Other Pertinent Information You'd Like Us to Know
If your child is in the Nursery, please let us know if:
Please select one option.
You'd like to be called to change your child's diaper.
You'd like nursery staff to change your child's diaper.
Your child is potty training.
Fourth Child's Name
Birthdate (month/day/year)
Grade
Medical Notes (Including Allergies) or Other Pertinent Information You'd Like Us to Know
If your child is in the Nursery, please let us know if:
Please select one option.
You'd like to be called to change your child's diaper.
You'd like nursery staff to change your child's diaper.
Your child is potty training.
Fifth Child's Name
Birthdate (month/day/year)
Grade
Medical Notes (Including Allergies) or Other Pertinent Information You'd Like Us to Know
If your child is in the Nursery, please let us know if:
Please select one option.
You'd like to be called to change your child's diaper.
You'd like nursery staff to change your child's diaper.
Your child is potty training.
Submit
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