PoP Kids Club Child Registration
Please fill out one form per child. This form helps us to safely care for your child and better connect with them and communicate with your family.
Child's Name
*
Parent email
*
This address will receive a confirmation email
Parent Phone
*
Mailing Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent Name(s)
*
Child's Grade in School
*
Child's Birthdate
*
Is this child baptized?
*
Please select one option.
Yes
No
No, but I would like more information about having this done.
Child's T-shirt Size - All are Children's sizes
*
Please select all that apply.
Extra Small
Small
Medium
Large
Does this child have any allergies?
*
Does this child have any other medical concerns our volunteers and staff should be aware of?
Tell us a little about your child? What do they like/dislike? Please share anything our volunteers can use to help capture the attention of your child in a lesson or activity..
Please share anything else we should know to take the best care of your child while they are attending a PoP Kids Event..
Submit
Description
Please fill out one form per child. This form helps us to safely care for your child and better connect with them and communicate with your family.
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