Hope Kids Pre-Registration

Please register each child you will be bringing. Child care is provided for birth-5th 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.
If you're child(ren) have any special needs, let us know here!