Hope Kids Pre-Registration

Please register each child you will be bringing. Child care is provided for birth-4th grade. If you have any questions, please feel free to contact us.

Child 1 Name: *
Child 1 Name:
Child 1 Gender *
Child 1 Date of Birth *
Child 1 Date of Birth
Let us know what grade your child is in so we can let our volunteers know! If your child is not yet in school, mark N/A.
Child 2 Name:
Child 2 Name:
Child 2 Gender
Child 2 Date of Birth:
Child 2 Date of Birth:
Child 3 Name:
Child 3 Name:
Child 3 Gender
Child 3 Date of Birth:
Child 3 Date of Birth:
Parent 1 Name *
Parent 1 Name
Parent 2 Name
Parent 2 Name
Emergency Contact Phone Number: *
Emergency Contact Phone Number:
Our number one priority is safety. Please provide a phone number where we can reach you in the event that we need to contact you while your child is in our care.