Midas Kids - Be a Midas Kid!

I Want To Be A Midas Kid!

Would you like to become a Midas Kid's Club Member? Make sure a parent or guardian fills out this section!

Please be careful to spell the child's name correctly, so it looks great on the printable certificate. Also, the e-mail address must be correct. All requests to join the Midas Kids Club are verified by e-mail.

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Enter Child's Full Name:

Enter Child's E-mail Address:

Enter Child's Birthdate:

Month Day

Year

OPTIONAL: Enter the child's mailing address and receive a FREE Midas car decal in the mail!

Address (line 1) :

Address (line 2) :

City:

State / Province:

Zip / Mail Code:

Country:


	Make sure all of your information above is correct, then click the "Submit" button.