Daughters of the King

Registration Form

2008-2009

Child’s name (s)                                                                            Grade

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Parents’ names ­­­__________________________________________________________

Address ________________________________________________________________

Phone #   Home_____________________      Cell __________________________ 

Email______________________________________________________________

In an emergency, if we can’t contact you, who would you like us to contact?

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Name of Emergency Contact                                               Emergency Phone #

Please list any medical information we may need to know (allergies, asthma, autism, etc.):

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If you won’t be picking up your child each week, who will?  Please explain if there are any legal custody issues (i.e.  a certain person doesn’t have legal custody, so don’t let them pick up child).

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