Kids Club Registration *Denotes Required Field * Title * First Name * Last Name * Email * Phone () – * Address 1 Address 2 * City State/Prov * Zip/Postal Code * Grade Entering in September 2024 * School Name * Child's Birthdate (MM/DD/YYYY) * Name of Parent(s) * Emergency Contact Name * Emergency Contact Phone Number * List any allergies or medical/behavioural concerns * I give permission for pictures/videos of my child to be taken/used for EBC Kids Club promotion.(Y/N)
