Cade Kids Sign up

Child Information

First name

Last name

Preferred Name

Birthday

Month

Day

Year

Age

Grade

Parent/Guardian Information

Parent/Guardian Name

Relationship

Cell Phone

Email

Address

Member of Cade?

Yes

No

Would you like to enter another parent/guardian?

Yes

No

Parental Communication

Preferred Contact

Text

Email

Phone Call

Household Information

Siblings attending Cade Kids?

Yes

No

Multiple households?

Yes

No

Primary language spoken at home?

Emergency

Emergency Contact

Relationship

Phone

Medical Information

Current Medications

EpiPen

Yes

No

Inhaler

Yes

No

Emergency Medical Instructions

Child Care Information

Potty Status

Potty Trained

Needs Assistance

Pull Ups

Diapers

Developmental/Behavioral/Learning Needs?

Yes

No

What helps your child feel comfortable?

Anything else we should know?

Permissions

Snack

Yes

No

Basic First Aid

Yes

No

Dietary Restrictions

Family Engagement

My child plans to attend:

1st Sunday

3rd Sunday

I am interested in volunteering

Yes

No

Parental Agreements

I will notify Cade Kids of medical/contact changes.

The Information provided is accurate.

I understand that my child will only be released to an individuals with a matching security tag.

I agree to the Cade Kids Parent Handbook.

Signature

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