skip to Main Content
**Each child requires a separate registration form**

Participant Information

Child's Name(Required)
MM slash DD slash YYYY


Please check to indicate the parent to contact for payment and other questions.
Mother/Guardian Name(Required)
Father/Guardian Name(Required)

Emergency Contact

If Parent or Guardian cannot be reached
1st Option Name
2nd Option Name

Authorized to Pick Up

Must be 18 years or older and provide a safe word or photo ID.
If you must send someone whom you have not placed on your authorized list to pick up your child, please call the program director at (864) 938-2795. A photo ID is required for pickup.
Back To Top