BBC KIDmin Pre-Registration
Parent/Guardian
Parent/Guardian First Name
Parent/Guardian Last Name
Email Address
Child Information
First Name
*
Last Name
*
Date of Birth
*
Mobile Number
*
Tip: We will use this number if needed during service
School Grade
-- None --
Nursery (birth - 2)
Pre-K & K (3-5)
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Graduated
Allergies
Emergency Contact Name
Emergency Contact Phone
Anything else you would like us to know
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