Lil' Kicks Registration Form

2:50PM – 3:30PM

18 mos – 2 years

11 in stock

Name

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

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)