CornerKid's Registration Card

Please use this form to register your child for CornerKids. If you fill this out by the Wednesday before you plan to attend, then your child’s information will be in our system. If you fill this out after Wednesday, please print a copy of your confirmation email so we may more quickly enter your child(ren) in our system.

First Name (*)

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Last Name (*)

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Nickname

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Date of Birth (*)

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Sex (*)

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What grade will this child enter this fall?

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School

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Parent(s) First Name & Last Names (*)

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Street Address, City, and Zip (*)

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Email

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Preferred Phone (*)

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Does this child have any allergies we need to be aware of?

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Please list additional kids name(s) & birthdates

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Special instructions

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