Kidz Club Registration Child's first and last name, school grade* Add each child separately with current school gradeParent / Guardian Contact Name* First Last Special Needs/Allergies*Please list any special needs, especially food allergies, as we do offer snacks. If none, please type "none"Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home / Primary Phone*Cell / Secondary PhoneEmail Photo Authorization*We strive for safety at all times. Kidz Club activities are photographed, and some of those photos are loaded to our website or used for promotional purposes. However, we NEVER use photos of a single child, only groups, and we NEVER publish names or any other pertinent information about a child. My child MAY appear in Kidz Club group photos My child MAY NOT appear in Kidz Club group photos EmailThis field is for validation purposes and should be left unchanged. Δ After submitting this form, don’t forget to return to the Kidz Club page and submit a Medical Registration Form for each child!