KidsCount - Register New Parent User

Program:

Online Request for New Parent Account

Please do not create a new account if you already have one in our system. If you are
having access problems or need access to another Kids Place location, please contact our staff.
Contact us by phone (865-933-7716) or email (kidsplace@kidsplaceinc.org). THANK YOU!

Select KP Site Your Child Will Attend

To create a new parent account, please provide the following information:

Parent/Guardian #1 (Primary Contact)

In cases of divorce or separation, please enter the parent with primary residential custody (the parent with whom the child resides the majority of the time) as Parent/Guardian #1. If the residential custody arrangement is 50/50, either parent may be entered.

First Name

Last Name

Gender

Relationship to Child(ren)

Primary Phone

E-mail Address (Username for Account Login)

Parent/Guardian #2

In cases where there is only one custodial parent, please check the "Does Not Apply" box. Otherwise, enter the information requested below.

Does Not Apply

First Name

Last Name

Gender

Relationship to Child(ren)

Primary Phone

E-mail Address (Optional)