Registration for Children's Programs

Please fill out the following information

* means that it has to be filled out
Children must be registered in Starrez as living in your apartment before they will be considered for a space in programs.
Please complete all sections of PARENT/GUARDIAN information. This information will be used when contacting parents about programs and emergencies.
PARENT/GUARDIAN INFORMATION
(Parent/Guardian 1)
(Parent/Guardian 1)
(Parent/Guardian 2) If there is a second parent/guardian that will be in Stillwater, OK and responsible for the child(ren).
(Parent/Guardian 2)
(Parent/Guardian 2)
EMERGENCY/PICK UP INFORMATION
Only parents/guardians and those listed here will be allowed to pick up child(ren). These people will also be contacted if we cannot reach the parents/guardians.
CHILD INFORMATION
Child 1 Name *
Child 1 Name
Child 1 Date of Birth *
Child 1 Date of Birth
Will you pick up this child or will they walk home? *
If no allergy, food, or medical restrictions please list "none."
If you have another child add all of their information below. If you do NOT have other children, please scroll to the end of the page and hit SUBMIT!
Child 2 Name
Child 2 Name
Child 2 Date of Birth
Child 2 Date of Birth
Will you pick up this child or will they walk home?
If no allergy, food, or medical restrictions please list "none."
Child 3 Name
Child 3 Name
Child 3 Date of Birth
Child 3 Date of Birth
Will you pick up this child or will they walk home?
If no allergy, food, or medical restrictions please list "none."
Child 4 Name
Child 4 Name
Child 4 Date of Birth
Child 4 Date of Birth
Will you pick up this child or will they walk home?
If no allergy, food, or medical restrictions please list "none."