Memorial Baptist Church Pasadena - MKA Enrollment Forms

Memorial Kids Academy

ENROLL NOW!

We’re excited to welcome your family to our center. To get started, you can download and complete the enrollment forms to bring with you to the center, or simply fill out the online enrollment form below. If you have any questions during the process, our team is happy to help. We look forward to meeting you and your child!

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Child Information

Single Choice

Full Time

Part Time

Drop In

Child Legal First Name

Child Legal Last Name

Childs DOB

Gender

Child's Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Parent/Guardian 1

Relationship to Child

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Primary Number

Parent/Guardian 2

Relationship to Child

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Primary Number

Primary Emergency Contact

(Other than parents or guardian)

Relationship to Child

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Primary Number

Secondary Number

May I text you?

Yes

Secondary Emergency Contact

(Other than parents or guardian)

Relationship to Child

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Primary Number

Secondary Number

May I text you?

Yes

Authorized Pick-Up List

If you plan on having someone else drop off/pick up your child, please fill out the following.

Relationship to Child

First Name

Last Name

Primary Number

Notes

Parent Signature

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Submit

ENROLL NOW!

Child Information

Parent/Guardian 1

Parent/Guardian 2

Primary Emergency Contact

Secondary Emergency Contact

Authorized Pick-Up List

Medical Information

Consent Information

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