Register online using the form below. Or click here to download the registration form to print. Registration Parents InformationMother's Name First Last Mother's PhoneMother's Email Mother's Occupation Father's Name First Last Father's PhoneFather's Email Father's Occupation Emergency Contact (other than parent) First Last Cell PhoneHome PhoneRelation to the child Child's InformationName First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birth dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Child's School Grade as of 2019-20 school year Please list any allergies and/or medical conditions that we should be aware of*Health Insurance Name Health Insurance Number In case of medical emergency requiring immediate emergency care, I authorize the paramedics to take my child to the nearest hospital, if necessary. What are your child's favorite activities?*What makes your child upset?*Does your child occasionally exhibit any of the following behaviors? Biting Cursing Grabbing Hitting Kicking Pulling Hair What is the best method of handling the situation? Δ Click here to download the brochure.