CHILD YOUTH PROGRAM REGISTRATION FORM Please print clearly NAME: MAILING ADDRESS: TOWNSHIP: POSTAL CODE: HOME TELEPHONE:.

 

YOUTH/TEEN PROGRAMS 10 AnnualFee YOUTH AGES:10 - 18 STILL IN HIGH SCHOOL PERSONAL INFORMATION YOUTHÕS NAME: AGE: DATE OF BIRTH: GENDER:.

 

Sunday School / Youth Programs Registration Form One form per family needed unless contact information for all children is not the same. PARENT INFO.

 

Sunday School / Youth Programs Registration Form One form per family needed unless contact information for all children is not the same. PARENT INFO.

 

Registration Form for Youth Participation in Programs Name of Program s Day if applicable ession if applicable Time of program if applicable ______ Level if applicable.

 

Interested in Helping Please check one: ex. : Soccer, Basketball, Lacrosse : I would like to be a volunteer. MI First Name Gender Birthdate mm/dd/yyyy.

 

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WASHINGTON BOROUGH RECREATION DEPARTMENT YOUTH BASKETBALL 201 NON - REFUNDABLE Boro Resident: 55 per participant / 90 per family Non - Boro Residents: 65 per participant / 110 per family Ages:.

 

Registration Form for Youth Participation in Programs Name of Program s Day if applicable ession if applicable Time of program if applicable ______ Level if applicable.

 

Page2 GROUP SWIM LESSONS Birth 55 first child/ 45 each add’l AGE Date AMT. DUE ____ _____ ________ ____ _____ ________.

 

Town of Somers Parks Recreation Department P. O. Box46 Somers, NY 10589 YOUTH PROGRAM PARTICIPANT INFORMATION FirstName LastName Gender male/female.

 

Youth   Program     ex:  Sports,   Child   Care, Day  Camp :     Child   Information: need,   additional         start to  ensure your  child  .

 

Mansfield Fish andGame 510 East Street Mansfield, MA 02048 www. mansfieldfish. com Youth Program 2012 Program Name: Program Date s : ___________.

 

Programname: Location circle one Hermitage Greenville Farrell LUVW KLOG¶V XOO 1DPH Date of Birth: Age: __ 6HFRQG KLOG¶V XOO 1DPH ____.

 

Children and Youth Programs Registration Form Child’s Information: Child’s Email Address: First Name: Last Name: Age: Gender:.

 

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Sunday School / Youth Programs Registration Form One form per family needed unless contact information for all children is not the same. PARENT INFO.

 

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Home Phone SECTION B - Please print - Program participant information Class ID Program Name Early Fee May 23,2014100Cal Ripken Baseball 10-12yr.

 

MFDP Youth Program Please complete all parts of this form. Print clear ly all information and sign the registration form and re lease of liability.

 

Name: Birth Date: Grade: ____________ 2012 - 2013 school year 3DUHQW¶V ,QIRUPDWLRQ Name: Address: Zip: ___________ Main.

 

JUNE FIT-KIDS REGISTRATION AGES 2-10 CHILD’S DATE OF AGE_____GRADE FALL ’10 ________ PARENT OR GUARDIAN DAYTIME PHONE: ____ __________HOME.

 

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P. O. Box 400 Daphne Recreation Department PH 251 621-3703 Daphne, Al 36526 Fax 251 621-3717 Coach Asst. Coach Your Name: ALL COACHES AND ASSISTANT COACHES MUST.

 

P. O. Box 400 Daphne Recreation Department PH 251 621-3703 Daphne, Al 36526 Fax 251 621-3717 _______________ Youth Small Youth Medium Youth Large Adult Small.

 

P. O. Box 400 Daphne Recreation Department PH 251 621-3703 Daphne, Al 36526 Fax 251 621-3717 Coach Asst. Coach Your Name: ALL COACHES AND ASSISTANT COACHES MUST.

 

YOUTH CAMP REGISTRATION PAGE 2 MEDICAL HISTORY of Family Doctor or Hospital or number of Date of last tetanus Known health Activity.

 

! ! ! ,- ! ! /0. / !. , 0-. 12 3-4 4. , GENERAL RELEASE OF LIABILITY AND INDEMNIFICATION In agreeing to participate in this program, I affirm that the general health of the named participant is g ood and that the named.

 

2013 JOHNSON CITY PARKS RECREATION 2013 For More Information / Returning Forms: Johnson City Parks Recreation 283-5822 Athletic.

 

Attachments Program Registration Requirement Checklist Name of Institution Address Program s Applied Tel/Fax No. Program Registration Requirements Compliant Remarks.

 

ADULT PROGRAM REGISTRATION FORM Please print clearly NAME: MAILING ADDRESS: TOWN: POSTAL CODE: HOME TELEPHONE: BUSINESS.

 

Carbon County Recreation Program Registration 30 East 200 South, Price, Utah You may be required to complete another registration form, depending on the program.

 

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V àç Éy ÄyÉÜw VÉÇÇxvà vâà --Founded 1639 - 70 West River Street – Milford, CT 06460-3317 Tel 203-783-3280 Fax 203-783-3284 www. ci. milford. ct. usDOB Child’sName DOB Activities Night.

 

Tel Fax: 416 447-3535 Crisis Line: 416 241-5456 E-mail: info futfs. org Web: www. futfs. org Registration for Youth Alive Soccer.