Please fill out the form below to re-enroll your child in KCRG for the 2011-2012 year.

Parents Name(s)
Address
Phone Number
E-mail
Child 1 Name
Child 1 Age or Grade on 9/1/11
Child 1 allergies or special needs
Child 2 Name
Child 2 Age or Grade on 9/1/11
Child 2 allergies or special needs
Child 3 Name
Child 3 Age or Grade on 9/1/11
Child 3 allergies or special needs
I consent to KCRG periodically taking photo or video of my child during the KCRG progam
Please check this box if you are interested in serving in KCRG
Please answer the simple math question below to submit the form.
2 + 2 =