Santa’s Rest Stop
registration

If more than two children are to be registered, please complete and submit another form.


Please note: santa’s rest stop is for children 3 years old through 6th grade.

CHILD(REN) INFO
Please complete the following information about the child/children to be registered
CHILD ONE
Child One: Name *
Child One: Name
Child One: Birthdate *
Child One: Birthdate
CHILD TWO
Child Two: Name
Child Two: Name
Child Two: Birthdate
Child Two: Birthdate
NOTE: If there are more than two children to be registered, please submit a second form for the additional children.
PARENT/CAREGIVER INFO
Please complete the following informtion as it applies to the child(ren)'s parent(s) or primary caregiver.
Parent(s)/caregiver name *
Parent(s)/caregiver name
Parent/Caregiver phone number *
Parent/Caregiver phone number
Home phone
Home phone
Home address *
Home address
IN CASE OF EMERGENCY
Emergency contact *
Emergency contact
Emergency contact phone *
Emergency contact phone