After-school KéKAY Kids Club
Today's date
What is the name of the school your child attends?
Parent/s first name
Parent/s last name
Email/s parents
Address
Phone number/s parents
How did you hear about us? If someone referred you, please list them below.
Name of child/ren
Grade of child/ren
Does your child/ren have any allergies . Please list the details.
What is the DOB of your child/ren
WAIVER - pdf format - print waiver on website, sign and upload here
Your waiver
OR WAIVER jpg format - print waiver on website, sign and upload here
Your waiver
Print credit card authorization from the link on the website and upload pdf format CREDIT CARD AUTHORIZATION here
Your Authorization Form
OR Print authorization from the link on the website and upload jpg format CREDIT CARD AUTHORIZATION here
Your Authorization Form
Did you pay the enrollment fee?
Did you sign up to pay monthly by credit card? Payments start on August 14th for 10 months.
Did you upload your waiver?
If you are signing up for a DROP-IN day, please list the dates below.
Submit
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