BrainerdKids Registration

Add adult Information at the top of this form, add children's information at the bottom of this form.

We look forward to meeting you and your family, It's best to register each member of your family before visiting Brainerd Kids; Please complete this form in its entirety, doing so will help us know how to best serve your family when you arrive.

Your name *

Email address *

ADD PARENT / GUARDIAN INFORMATION HERE

*This section is to collect information for the Parent/Guardian listed above*

Phone number *

Consent to Text

These text updates are designed to keep parents and guardians informed about their child(ren) while in our care. Notifications will include updates about your child, inclement weather alerts, and emergency notifications as needed. Your information will remain confidential and will not be sold. You can opt-out at any time. Message and data rates may apply.

Address *

Gender *

Birthdate *

ADD CHILDREN'S INFORMATION HERE

Household members

Parental Rights

Please tell us if there are any current Legal, Child Custody, Visitation, or Support issues that we may need to be aware of.

What Campus Do You Plan To Attend? *

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