Kids Going Bananas

Child 1 Information: First Name* Gender* Date of Birth* mm/dd/yyyy School Attending*	Last Name* Age* Grade* Signing up for:*
Child 2 Information: First Name* Gender* Date of Birth* mm/dd/yyyy School Attending*	Last Name* Age* Grade* Signing up for:*
Child 3 Information: First Name* Gender* Date of Birth* mm/dd/yyyy School Attending*	Last Name* Age* Grade* Signing up for:*
Parent Information: Parent Name* City* Zip Code* Cell Phone Mother's Work Phone* Father's Work Phone*	Address* State* Phone Number* E-mail* Mother's Place of Employment* Father's Place of Employment*
Emergency Contact (other than the parent) Full Name*	Phone*
*Check this box to accept these* terms and conditions.
Special Instructions* Please place in this box any special instructions for your child including: allergies, medications, special needs, etc. If signing up for Summer Camp, please place in this box also the weeks you are signing up for.