Marketplace Registration
June 20-23, Tuesday-Friday
Please fill out the form for each child
What is the child's first name? *

What is the child's last name?

What is your child's birthday? *

What year in school did your child complete for year 2016/2017? *

Does your child have allergies or other medical conditions for us to know about?

What is your name? *

What's your relationship to the child? *

Email address? *

Phone number? *

best emergency number during the day (in case we need to call during Marketplace)
Address? *

Anything else we should know?

Code word for pickup

Whoever is picking up your child (i.e. grandparent, dad, etc.) will need to know this word
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