KidsCAN Bake Registration Form
Five week After School program Mondays, April 13 - May 4th
Name of child
*
Birth Date
Address:
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Name of Parent/Guardian
E-mail
example@example.com
Home Number
Cell Number
Alternate Contact/ authorized to pick up child:
Do you consent for your child to be in photos?
Yes I consent
No I do not consent
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Registration Fee
1 Child all sessions
$
50.00
CAD
Credit Card
Submit Form
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