Registration Form

LITGROUPS 2023 Fall Registration

 

Please fill out the registration form below.

 

Also be sure to read:

Registration Information

Name of Participant (First Name, Last Name):*
Address:*
Phone number:*
-
Date of Birth:*
Gender:

Program Information

I would like to register my child for (select one):
My child will be:*
The people who have permission to pick up my child are:
Additional comments:

Parent / Guardian Information

Your relationship to the participant:*
Parent / Guardian Address:*
Parent/Guardian E-mail:*
Emergency Contact number:*
-
Emergency Contact number #2:
-

Medical Information

Allergies (list here):
Dietary allergies, issues, concerns (list here):
Medications required by participant:
Please share any additional information that would make your child's experience at this LITGROUPS event more successful

Parent Contract


I consent to my child/ward attending the YFC LITGROUPS program for the above selected dates.*
I give permission for YFC to obtain personal information about my child/ward for the purposes of communications and registration requirements.*
I give permission for my child's/ward's photo to be taken and used in the communication and promotion of YFC events.
I have read and understand the parent information document. (link at top of page)*
Parent / Guardian Name:*
Date:*