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KMC Onstage Theater
Please complete the following information about your household
* REQUIRED DATA
User Name (up to 50 chars)
Password (up to 50 chars)
Re-Type to Confirm
Head of Household Information
Name of Primary Guardian (First)
Name of Primary Guardian (Last)
Gender
Male
Female
Undeclared
Date of Birth (mm/dd/yyyy)
School Grade
or highest grade
completed highest grade completed
Unspecified
Pre-K (0-3)
Pre-K (3-5)
Kinder
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Other
Secondary Guardian Information
Name of Secondary Guardian (First)
Name of Secondary Guardian (Last)
Gender
Male
Female
Undeclared
Date of Birth (mm/dd/yyyy)
School Grade
or highest grade
completed highest grade completed
Unspecified
Pre-K (0-3)
Pre-K (3-5)
Kinder
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Other
Email and Phone Information
Primary EMail Address
Re-Type to Confirm EMail Address
Home Phone w/ area code xxxxxxxxxxxxxxx
Work Phone w/ area code xxxxxxxxxxxxxxx
Work Extension
Address Information
Mailing Address
Street Address
if different
City
State
Postal/Zip Code
Country
Emergency Contact Information
Name of Emergency Contact (First)
Name of Emergency Contact (Last)
Contact Phone w/ area code
Relationship
#1
Cell Phone w/ area code xxxxxxxxxxxxxxx
Military/Civilian Status
--Choose One--
Active Duty Mil (AR/AF/NA/MC)
Active Duty Coast Guard
Full Time National Guard
Full Time Reservist
Eligible DOD Contractor
DOD Civ (APF/NAF/AAFES/DODDS)
Non-DOD Federal Employee (GSA/NSA/etc)
Sponsor=Disabled Veteran
Sponsor=Private Sector Civilian
Retired Military
Student
Unemployed
If Military, Branch
N/A
If Military, Grade/Rank
N/A
* REQUIRED DATA
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