First Time to Harborside Kids Email Please check all service times you will attend: * 9:00am 10:30am Child's Name * Child's Name Child's Name Child's Name Grade/Age * Grade/Age Grade/Age Grade/Age Gender * MaleFemale Gender MaleFemale Gender MaleFemale Gender MaleFemale Date of Birth * Date of Birth Date of Birth Date of Birth Parent Info: Mother's Name * Address * Phone * Date of Birth * Email * Father's Name * Address * Phone * Date of Birth * Email * List any allergies/medical concerns: Authorized Adult(s) allowed to drop off/pick up: *
