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    This registration form is for Campbell's Kids Club before and after school program. It collects information about the child, including name, birthdate, grade, start date, and what days before and after care are needed. It also collects contact information for two parents/guardians, including their names, addresses, email addresses, home, cell, and work phone numbers, and the employer of each parent.

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    This registration form is for Campbell's Kids Club before and after school program. It collects information about the child, including name, birthdate, grade, start date, and what days before and after care are needed. It also collects contact information for two parents/guardians, including their names, addresses, email addresses, home, cell, and work phone numbers, and the employer of each parent.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    124 views1 page

    Registration Page 1

    Uploaded by

    api-314708963
    This registration form is for Campbell's Kids Club before and after school program. It collects information about the child, including name, birthdate, grade, start date, and what days before and after care are needed. It also collects contact information for two parents/guardians, including their names, addresses, email addresses, home, cell, and work phone numbers, and the employer of each parent.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
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    Download as doc, pdf, or txt
    of 1

    CAMPBELLS KIDS CLUB, LLC

    2 FOUR CORNERS ROAD


    BLAIRSTOWN, NJ 07825
    BEFORE AND AFTER SCHOOL PROGRAM
    REGISTRATION FORM
    CHILD: ___________________________________________________________________
    Birth Date: ______________________________________________
    Grade as of 9/1/16:

    Gender: F

    _____________________________________

    Start Date:

    ___________________________________________

    Before Care:

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    After Care:

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Please circle days needed

    PARENT / GUARDIAN #1:


    Name: _______________________________________________________________________________________
    Address: _________________________________________________________________________

    _________________________________________________________________________
    City

    Email:

    State

    Zip

    _______________________________________________________________________________________

    Home Phone: ____________________________________Cell Phone: ____________________________________


    Employer: ________________________________________Work Phone: _________________________________

    PARENT / GUARDIAN #2:


    Name: _____________________________________________________________________________________
    Address: _______________________________________________________________________

    _____________________________________________________________________________
    City

    State

    Zip

    Email: ______________________________________________________________________________________
    Home Phone: ____________________________________Cell Phone: __________________________________
    Employer: _______________________________________Work Phone: ________________________________

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