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 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?
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?
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?