Please fill out the information below.

If you have any questions before completing the form, email kids@radius.la.

Parent's Full Name(s)
Parent's Full Name(s)
Child's Full Name
Child's Full Name
Child’s Date of Birth
Child’s Date of Birth
Mailing Address
Mailing Address
Phone
Phone
Some families choose Godparents. If you would like us to publicly acknowledge Godparents, list their name(s) below.
If you have family members attending that you would like to publicly acknowledge, list them below.
If you have friends or important people attending that you would like to publicly acknowledge by name, list them below.