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kidz birthday club

Enrollment Form

Please allow at least 6-8 weeks from when we receive your registration form for your child(ren) to be enrolled and eligible to receive their birthday card.

Journeys Kidz Birthday Club is for children up through the age of 12.

Parent / Guardian Information
First Name * Last Name * MI Title Gen.
e-mail address * confirm e-mail address *
Address Line 1 * Apt / Floor / Room
Address Line 2
City* State* Zip*
Date of Birth (MM/DD/YYYY)*
Child #1
First Name * Last Name * MI Gen.
 
Birthdate (mm/dd/yyyy) * Boy* Girl*  
Child #2
First Name Last Name MI Gen.
 
Birthdate (mm/dd/yyyy) Boy Girl  
Child #3
First Name Last Name MI Gen.
 
Birthdate (mm/dd/yyyy) Boy Girl  
Child #4
First Name Last Name MI Gen.
 
Birthdate (mm/dd/yyyy) Boy Girl  
Child #5
First Name Last Name MI Gen.
 
Birthdate (mm/dd/yyyy) Boy Girl  
Digital Signature
First Name * Last Name * Date * (mm/dd/yyyy)
Yes! I would like to receive special discounts and offers by email.
Please send me a Journeys Kidz catalog by mail
By entering your name and pressing "SIGN ME UP!," you are signing this record and verifying to Journeys Kidz that you are (1) the parent or legal guardian of the child(ren) listed above, (2) 18 years of age or older; and (3) consenting to register the child(ren) listed above into the Journeys Kidz Birthday Club.
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