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GATEWAY KIDS NEW FAMILY REGISTRATION

Register your family by Thursday morning and use our check-in computers on Sunday morning to check your kids into their classes.

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Parent/Guardian Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian Mobile Phone *

Parent/Guardian Email *

Child's Register Child

Parent/Guardian#2 Name

First

Last

Please include spouse or other adult who is allowed to pick up children from the rooms.

Parent/Guardian #2 Mobile Phone *

Parent/Guardian #2 Email *

#2 address is different

Check this box if Parent/Guardian #2's address is different.

Parent/Guardian #2 Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

Child 1 Registration

Child's Name *

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

Add Another Child

Child 2 Registration

Child's Name *

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

Add Child #3

Child 3 Registration

Child's Name

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

Add Child #4

Child 4 Registration

Child's Name

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

Add Child #5

Child 5 Registration

Child's Name

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

Add Child #6

Child 6 Registration

Child's Name

First

Last

Child's Gender *

Male
Female

Child's Birthdate *

Child's Grade

Any Allergies or Medical Conditions (if applicable)

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