Sunday Funday Application 5 Towns Apply Online Please fill out all the required fields, and click Submit when you are done. Are you already a Glick Girl? If you have previously filled out an application, just fill in your First and Last Name, and complete steps 1, 4 and 6. I am already a Glick Girl Email Address 1. Child Information: NEW! Register more than one child at a time! Child #1 First Name School Grade ---NurseryKindergartenPre 1A1st Grade2nd Grade3rd Grade4th Grade5th Grade Child #2 First Name School Grade ---NurseryKindergartenPre 1A1st Grade2nd Grade3rd Grade4th Grade5th Grade Child #3 First Name School Grade ---NurseryKindergartenPre 1A1st Grade2nd Grade3rd Grade4th Grade5th Grade 2. Personal Information Father's Name Mother's Name Last Name Email Address Address City State Zip Code Home Phone Number Mother's Cell Number Father's Cell Number Doctor's Name Doctor's Phone Number 3. Emergency Contact: Please list someone who can be contacted in case of an emergency if we cannot get in touch with both parents. Name Relation Home Phone Number Cell Phone Number 4. Payment Method: I'd like to pay by credit card online.Chase Quick Pay: firstname.lastname@example.org 5. Special information: Does your daughter have any allergies or on any medication? Any special information you think we should know about your daughter? 6. Submit I give permission for the staff at Glick to deal with any medical emergencies and make any necessary medical decisions, and I agree to the terms and conditions as seen here. Electronic Signature - Please fill in your full legal name.