We'd love for you to join us! Just ask Mom or Dad to help you. Hey Mom & Dad - To register, please fill out the form below. You may complete your registration securely online, or fill out the form, print it, and bring it to a participating mall. Each child will receive a T-shirt and a Simon Kidgits Club® Membership Card.

Parent must complete registration, and by doing so, agree to the Simon Kidgits Club® Terms and conditions.  $5.00 annual membership per child.

View the Terms and conditions. View the Simon Kids Online Privacy Policy.


KID'S INFORMATION

View the Simon Kids Online Privacy Policy.
 
*Child's First Name:  
 
*Child's Last Name:  
 
*Child's Gender:  
 
*Child's Birthday:  
*Membership Term:  


PARENT'S INFORMATION


*First Name: M.I.: *Last Name: Suffix:
 
 
*Parent's Address:  
 
Parent's Address Con't:  
 
*City: *State: *Zip:
 
*Phone Number:   ()-
       
*E-mail Address:      
*Confirm E-mail Address:  
 
*Gender:    
 
 
*Preferred Simon Mall: