IPPC 2023 CHILDCARE PRE-REGISTRATION FORM
CHILD'S FULLNAME
CHILD'S AGE
CHILD'S DATE OF BIRTH
GENDER
Please select
MALE
FEMALE
COUNTRY
Required *
ZONE
Required *
CHURCH
ALLERGIES IF ANY
MEDICAL ALERTS TO BE MNDFUL OF, IF ANY
SPECIAL NEEDS IF ANY
PARENT'S NAME
Required *
PARENT'S KC HANDLE
Required *
PARENT'S KC PHONE NUMBER
Required *
PARENT'S EMAIL ADDRESS
Required *
ALTERNATIVE PHONE NUMBER
CONFERENCE ARRIVAL DATE
Required *
Please provide any additional Information about your child, below: (Is there anything to be concerned about).
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