Kids Registration Info - The Italian Cultural Society

Primary Adult Contact*

First Last

Primary Adult Email*

Primary Adult Phone*

Secondary Adult Contact Info

List adults you authorize to pick up your children.

Child’s Full Name*

First Last

Child’s Age*

Notes or Concerns

Please list any social or health issues, including allergies.

Add Siblings

2nd Child’s Full Name

First Last

2nd Child’s Age

2nd Child - Notes or Concerns

Please list any social or health issues, including allergies.

3rd Child’s Full Name

First Last

3rd Child’s Age

3rd Child - Notes or Concerns

Please list any social or health issues, including allergies.

Allow photos or video*

Comments

This field is for validation purposes and should be left unchanged.