The King's Kids Youth Development Center

Spring-Break Camp Enrollment Interest Form

Thank you for choosing The King’s Kids Learning Center! Enrollment is open to ages 5-12 years old (must be fully potty trained). Please fill out this form to initiate the enrollment process and if there's space, our Enrollment Management team will email you with further instructions. If space isn't currently available, your child will be placed on the waiting list.

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Contact Information:

Full Name:

Relationship to Child:

Email Address:

Phone Number:

Preferred Method of Contact:

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Child Information:

Child's Full Name:

Date of Birth

Gender:

Any Special Needs or Allergies:

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Program Preferences:

Desired Start Date:

Age Group:

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Additional Questions:

How did you hear about our childcare center?

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Emergency Contacts: Names and Phone Numbers of Emergency Contacts (other than parents/guardians)

Emergency Contact 1 Name:

Phone:

Emergency Contact 2 Name:

Phone

Emergency Contact 3 Name:

Phone

Any specific requests or additional information:

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Spring-Break Camp Enrollment Interest Form

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