Community Education - current class catalogs Project Power - Fall 2015 | Page 23
Fall 2015 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
Day
Year
REQUIRED - Legal guardian/Emergency contact:
Guardian name: ________________________________________________ Phone: ____________________________
Sports & exercise
Out &
about
Laugh &
learn
Cooking
& dining
Arts &
crafts
Music &
theatre
Emergency contact: ____________________________________________ Phone: ____________________________
(Emergency contact must be able to be reached during class time, not a voicemail or machine.)
Christmas in the Airways
at Lyric Arts
Merry Music Makers
The Monkey King Play
Fall Flower Pots
Fall Wreath
Fleece Scarves
Glass Fusion
Inspirational Rock Painting
Jack-O-Lanterns
Cooking 101Fruit Pancakes & Fixins
Cooking 101-Tortilla Pizza
Dinner at Old Country Buffet
September 28
November 9
Pumpkin Bars
Thanksgiving Dinner
Bingo
Fall Kickoff Party
Halloween Dance Party
Life Skills-Budgets 101
Movie & Subs
Read with Haylee the Dog
Bakken Musuem
Campfire & Hayride
Corn Maze & Pumpkin Patch
Grand Slam
Riverboat Cruise & Lunch
Vikings Game & Pizza
Bowling & Pizza with Dirk & Perry
September 25
Participant ______ $29
Participant ______ $45
Participant ______ $15
Participant ______ $25
Participant ______ $19
Participant ______ $15
Participant ______ $25
Participant ______ $15
Participant ______ $19
Staff ______ $9
Staff ______ $19
Staff ______ $15
Participant ______ $19
Participant ______ $19
Staff ______ Free
Staff ______ Free
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