Parks and Recreation

Child’s Name:(required)

Child’s age:(required)

MaleFemale

Grade (entering the 2024 –2025 school year. Must be entering 7TH grade-9TH grade) (required)

Address: (required)

Your Telephone Number (required)

Your cell Number (required)

Emergency Contact:(required)

Emergency Contact Telephone Number (required):

Your Email (required)

I acknowledge that I have read and agree with all of the rules of the program and that the information provided above is accurate. I acknowledge that enrolling my child in the program you are assuming risks of medical expenses for my child that may be incurred due to any accidents.