Lil' Kicks Registration Form

2:10PM – 2:50PM

18 mos – 2 years

4 in stock

Parent/Guardian Name(Required)

Email(Required)

Enter Email Confirm Email

Phone Number(Required)

Street Address(Required)

Street Address Address Line 2 City Postal Code

Emergency Contact & Phone Number(Required)

Lil Kicker's Information(Required)

Birthday(Required)

Do you give permission for photos taken to be posted on our website (lilkickstbay.ca) and social media (Facebook)?(Required)

Name

This field is for validation purposes and should be left unchanged.