SummerRec

Summer Recreation 2020 Registration Form

* Indicates required field

Child's Name *

First

Last

Child's Birthdate (mm/dd/yyyy) *

Parent or Guardian Name *

First

Last

Parent/Guardian Email *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Work Phone Number *

Preferred phone *

Cell Home Work

Contact other than Parent *

Contact's relationship to child *

School child will be attending 2020-2021 *

Child's grade in 2020-2021 school year *

Home Church or place of worship (if one) *

Allergies & Medications *

Optional T-Shirts: Please list below the names and sizes for Summer Rec T-shirts. Each shirt is $10 and can be paid at time of registration or by June 24th at the latest. The shirt comes in children's sizes as well as adult.

Name to go on shirt *

T-shirt size *

Submit

Summer Recreation 2020 Registration Form

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