Journey Kids Online Registration Form

Parent/Guardian's Name(s)
Phone
Address
City
Zip

First Child's Information

Child's Name
Date of Birth
Allergies or Special Needs

Second Child's Information

Child's Name
Date of Birth
Allergies or Special Needs
Date of Birth

Third Child's Information

Child's Name
Date of Birth
Allergies or Special Needs

Fourth Child's Information

Child's Name
Date of Birth
Allergies or Special Needs
If you need to register more than 4 children, nplease submit the form and add them via a new form.