Monroe Crossing :: Kids Club

Monroe Crossing's Kids Club Registration Form

I give my child permission to join Monroe Crossing's Just Kid-ding Around Kids Club. I understand that my child/I will receive periodic emails from Monroe Crossing with information about new events and activities through the mail. All information given is not to be distributed to any other sources. Monroe Crossing keeps the privacy of all information. My authorization below indicates I agree to the terms.

*Parent First Name

*Parent Last Name

*Parent's E-mail

*Address:

*City:

*State:

*Zip:

Your Child(ren)'s First Name and Birth Date*
Must be 13 years or under to enroll for the the Kids Club
	First Name	Month	Day	Year
*Child 1:
Child 2:
Child 3:
Child 4:
Child 5:

How did you hear about the Kids Club?

Send my information in HTML format.

Please enter text in image:

I certify that I am over the age of 18. I have read Monroe Crossing's Privacy Policy and agree to the terms of the policy and terms of use statement.

I confirm that I am the parent or legal guardian of the child named above.

I consent to my child receiving information on the Kids Club Program at the address listed above.