Childcare Registration

On Sunday, December 15th, we will be hosting the 2024 KC Underground Fundraising Event. Thank you for providing us with the information below so we can prepare to care for your child in the best ways possible. Childcare will be offered for children ages birth-5 years of age.

First Name *

Last Name *

Phone *

Email *

Address *

City *

State *

Postal code *

Child #1 name

Child #1 date of birth

Child #1 school grade

Child #2 name

Child #2 date of birth

Child #2 School Grade

Child #3 Name

Child #3 date of birth

Child #3 School Grade

Child #4 Name

Child #4 date of birth

Child #4 School Grade

Child #5 Name

Child #5 date of birth

Child #5 School Grade

Special Instructions (e.g. allergies, etc.)/Comments: