Puggles Child Registration Form

Your Child's Name*
Parent(s)*
Parent(s) phone number*
Parent(s) cell phone number
Grandparent(s)*
Grandparent(s) phone number*
Grandparent(s) cell phone number
Other Adult With Permission To Pick Up Child*
Other Adult phone number*
Other Adult cell phone number
Address*
City / State / Zip*
Date of Birth*
My church home is
We have snacks and water (soft drinks on special occasions)
Any Food Allergies? *
 Yes
 No
If yes, please list any food allergies
Any physical conditions your child may have that we need to be aware of?*
 Yes
 No
If yes, please list below
Is your child toilet trained?*
 Yes
 No
T-shirt Size


Submit