KidCon Jr. Registration

Child First Name *

Child Last Name *

School Grade Entering in Fall *

Gender *

Child has Special Needs/Allergies *

Comments:

Tip: Please give us any additional information regarding your child's special needs or allergies.

Parent/Guardian Full Name (Primary) *

Parent/Guardian Full Name (Secondary)

Mobile Number *

Tip: Providing your cellphone carrier enables us to contact you via text message with information regarding your child.

Email Address *

Kingsway Church has permission to use photographs or video of my child in any and all publications and all media pertaining to KidCon *

Yes, I give permission for Kingsway to use a photo of my child(ren)

No, I do not give permission for Kingsway to use a photo of my child(ren)