Children & Youth Activity
Registration Form

Please complete and submit one form for each participant.
Child's age as of 09/01/2007
Child's name:
Gender:
 Female
 Date of birth:
Male
City
Address
 Zip Code
Email Address:
Parent/Guardian Name(s):
Home Phone Number:
Cellphone:
School Child Attends:
Grade completed
Church Affiliation:
I am willing to drive students to Back 2 School Bash:
I am willing to be a chaperone pool party:
I am willing to be a chaperone pool party:

Activities for which you are registering (Press and hold control key while pointing mouse button and clicking on all applicable choices):
For more information on events, such as age requirements, costs, time, and what to bring, please check out our
children and youth pages!