Child Registration Form
 
1

*Please input N/A for any fields that DO NOT apply to you.

Need help?  Please email us with any questions or concerns with registering at DiscoveryCenter@pg.com

 

Why do we require this information?

This information allows us to create representative consumer testing panels, and also ensures that registrants meet eligibility requirements.

 
Your Child's First Name:
Your Child's Last Name:
E-mail address:
 
2 What is your child's gender?
 
Male
Female
 
3 Is your child of Hispanic or Latino origins?
 
   
 
4 What is your child's race/ethnicity?
 
Asian
Black or African American
White
Other, please specify
 
5
 
Your Child's Date of Birth
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