JourneyKids Registration Form

Parents' or Guardians' Information

Parents' or Guardians' Name 1 - Relationship to Child

Parents' or Guardians' Name 2 - Relationship to Child

Address, City, State and Zip

Phone Number

Email

Child's Information

Child's Name

Birthdate

Age

Current School Grade

Additional Child's Information

Child's Name

Birthdate

Age

Current School Grade

Additional Child's Information

Child's Name

Birthdate

Age

Current School Grade

Please provide any special instructions and/or allergies your child might have to ensure the best possible experience!

Special Instructions

Allergies

Thank you so much for registering your child(ren) in JourneyKids. We look forward to seeing you soon!