Children Activity Registration

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 Info
only these listed will be allowed to pick up child
Optional!
Child's Pick up Information
only these listed and parent will be allowed to pick up child
Child Information
Child 1 Name *
Child 1 Name
Child's Date of Birth *
Child's Date of Birth
Additional Children Information (This is optional)
If you have another child that would like to be in the program. If not please hit submit!!
Child 2 Name
Child 2 Name
Child 2 Date of Birth
Child 2 Date of Birth
Child 3 Name
Child 3 Name
Child 3 Date of Birth
Child 3 Date of Birth
Child 4 Name
Child 4 Name
Child 4 Date of Birth
Child 4 Date of Birth