First Check SecurityForm: Children's Building "First Check"

Security Program Information

Data entry into our "First Check" security computer system is required for entrance into the new children's facility:

required fields

*CHILD 1: Full Name
*Birthdate (mm/dd/yy):
  Current Grade:
  Allergies/Special Needs:
CHILD 2: Full Name
Birthdate (mm/dd/yy):
  Current Grade:
  Allergies/Special Needs:
CHILD 3: Full Name
Birthdate(mm/dd/yy):
  Current Grade:
  Allergies/Special Needs:
*Guardian's/Father's Full Name:
*Guardian's/Father's Cell Phone:
*Guardian's/Mother's Full Name:
*Guardian's/Mother's Cell Phone:
*Address:
*City, State: *Zip:
*Home Phone:
*Email:
What programs are
you registering your
child/children for?

(Mothers of Preschoolers)

)

(please list):
   

NOTE: If you have more than three that are 5th grade and under, please first submit these above by clicking the "submit" button below, and then return to this page to submit a new form for other children.

After clicking the "Submit Form" button below, please wait for your confirmation page.



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