Community Education - current class catalogs Project Power - Fall 2014 | Page 19

Fall 2014 Registration Form
(ONE FORM PER PERSON / THIS FORM MAY BE REPRODUCED)

Participant/Staff Information: (No participant substitution without prior notice.)
Participant Name: _____________________________________________________________ Phone: _______________________________
Address: __________________________________________________________

City: ________________________ Zip: ______________

Email: ____________________________________________________ (for Class Confirmation) Birth Date: ________ / _____ / _________
Month

Legal Guardian/Emergency Contact:

Day

Year

REQUIRED

Guardian Name: ________________________________________________ Phone: ____________________________

SPORTS &
EXERCISE

OUT &
ABOUT

MUSIC &
THEATRE

LAUGH &
LEARN

COOKING ARTS &
& DINING CRAFTS

Emergency Contact: ____________________________________________ Phone: ____________________________
(Emergency Contact must be able to be reached during class time, not a voice mail or machine.)
Crayon Candle Making
Fiber Art Designs
Hodge Podge Trinket Painting
Pumpkin Carving
Simple Halloween Decorations
Cooking 101-Pork Chops
Cooking 101-Turkey Goulash
Dinner at KFC
Dinner at Pizza Ranch
Spooky Eats
Thanksgiving Dinner
Feed My Starving Children
Gobble Gobble Bingo
Halloween Dance Party
MN Zoo Mobile
Movie & Dinner
North Metro TV Studio Tour
November 17
November 24
Flash Mob Dance Squad
Merry Music Makers
Young Frankenstein the Musical
Corn Maze
Games & Burgers

Participant ______ $15
Participant ______ $15
Participant ______ $9
Participant ______ $9
Participant ______ $9
Participant ______ $15
Participant ______ $15
Participant ______ $15
Participant ______ $15
Participant ______ $15
Participant ______ $15
Participant ______ Free
Participant ______ $9
Participant ______ $15
Participant ______ $15
Participant ______ $15

Hayride & Campfire
Science Museum of MN
Special Olympics Truck Convoy
Vikings Game & Pizza
Basketball
Bowling with Dirk & Perry
October

Participant ______ $19
Participant ______ $29
Participant ______ $15
Participant ______ $19
Participant ______ $25

Participant ______ $9
Participant ____ }|