KC26 Kids Club 2026-2027 Registration

2026-2027 Kids Club Registration
Child's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Gender
Grade in September (enter "0" for Kindergarten)
Please indicate the grade your child will be entering in the 2026-2027 school year.
Name of Child's School
School Location (Town)
Attendance Options (includes transportation)
A $250 deposit is required*

Payment Options:
Visa/MasterCard/American Express, or electronic bank transfer

There is a $75 drop fee that will be applied to any child withdrawn from the program.

Kids Club is a 10-month program

*Deposit is nonrefundable after July 1.

Parent/Guardian A Name

First NameLast Name
Parent/Guardian A Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian A Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian A Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian A Email
example@example.com
Parent/Guardian B Name

First NameLast Name
Parent/Guardian B Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian B Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian B Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian B Email
example@example.com
EMERGENCY CONTACT INFORMATION
Emergency Contact Name

First NameLast Name
Relationship
Day Phone
Please enter a valid phone number.Format: (000) 000-0000.
Doctor's Name
Doctor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list any allergies or medical needs (or type "NONE")
PICK UP INFORMATION

Please list the names of adults permitted to pick up your child(ren).
Person A

First NameLast Name
Relationship to Child
Person B

First NameLast Name
Relationship to Child

Please Check All

Participation in any JCC MetroWest activity and use of any recreational facilities involves risk of accidental injury despite all safety precautions. Having been informed of the activities to be conducted by JCC MetroWest, I/we, as an individual or guardian of the participant(s) named herein, assume all risks and hazards incidental to the activities, and release from responsibility independent contractors, volunteers and all employees for any illness or injury to me or my children or family members occurring during his/her/our participation in any activities or use of any facilities at or conducted by JCC MetroWest.
Signature of Parent/Guardian
Today's Date

MonthDayYear
Date
Should be Empty:

2026-2027 Kids Club Registration