MetroKids' Club 2023-24

Please complete one form per child. Thank you.

Child's Name

*

Child's Birthdate

*

Child's Current Grade

*

Please select all that apply.

Nursery/Toddler K3 K4 K5 1st 2st 3rd 4th 5th

Allergies or medical conditions

*

Parent/Guardian Name(s)

*

Address

*

Phone

*

Email

*

This address will receive a confirmation email

Emergency Contact if parent/guardian cannot be reached - name & phone number please:

*

Does your family attend a local church?

*

Please select all that apply.

Yes No

If yes, which one?

Metro North Church has permission to use photos or videos of my child listed above in church presentations or church promotional materials.

*

Please select one option.

Yes No

Payment

1 child ($15.00) Pay At Church (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please complete one form per child. Thank you.

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