FALL 2025 registration form

( ONE FORM PER PERSON / THIS FORM MAY BE REPRODUCED)

Participant / Staff information:( No participant substitution without prior notice.)

Name of Participant name: ______________________________________ Phone: _______________ Group Home: ________________

Address: __________________________________________________________ City: _____________________ Zip: ___________

Email: __________________________________________( for class confirmation)

Birth date: _____ / _____ / ________ REQUIRED- Legal guardian / Emergency contact( must be able to be reached during class time.): ________________________________

_______________________ ____________________________ ______________________

Legal guardian name Phone No. Emergency contact name Phone No.

Special Accomodations: � Wheelchair

� Allergies ______________________________ � Other _____________________________ Staff must remain on site: � Yes � No Photo Release: � Yes � No � ASL Interpreter ___________________

A Holly Jolly Birdhouse		___ $ 15
Anoka Middle School Play		___ $ 15
Basketball		___ $ 39
Bingo
Sep 10		___ $ 12
Oct 15		___ $ 12
Nov 19		___ $ 12
Dec 17		___ $ 12
Breakfast for Dinner – Reindeer Pancakes ___ $ 19
Candy Molds		___ $ 19
Clay Pot Minions		___ $ 19
Cocoa and Carols with Claire		___ $ 12
Crafty Artists Art Night!
Sep 4		___ $ 12
Oct 21		___ $ 12
Nov 6		___ $ 12
Dinner and Treats at DQ
Sep 23		___ $ 15
Cheeseburger	Hot dog	Chick. strip
Oct 13		___ $ 15
Cheeseburger	Hot dog	Chick. strip
Dinner Sammy’ s Pizza Oct 1		___ $ 25
Dec 9		___ $ 25
DIY Scented Sachets		___ $ 15
Fall Social – Root Beer Floats		___ $ 9
Floor Hockey		___ $ 39
Friday Night Bowling
Sep 19		___ $ 24
Oct 10		___ $ 24
Nov 14		___ $ 24
Dec 12		___ $ 24
Gingerbread House		___ $ 19
Grand Slam		___ $ 24
Halloween Bowling Night		___ $ 24

Payment is due at the time of registration. Refund and cancellation policy: Requests with at least five business days notice from the class start date are eligible for a refund minus a $ 10 processing fee. Refund requests with less than five business days notice from the start of class are not eligible for a refund.

Halloween Dance	___ $ 19
Halloween Gingerbread Haunted House ___ $ 19
Happy Scarecrow Painting	___ $ 22
Hayride and Bonfire	___ $ 22
Holiday Dance	___ $ 19
Holiday Sugar Cookies	___ $ 19
Holiday Wall Decor	___ $ 15
Jolly St. Nick Painting	___ $ 22
Karate	___ $ 40
LEGO ® Social
Sep 17	___ $ 12
Nov 17	___ $ 12
Merry Music Makers	___ $ 55
Movie and Pizza Night	___ $ 20
Movie and Sub Night	___ $ 20
Movie and Taco Night	___ $ 20
Music with Claire	___ $ 12
Music with Claire – Holiday Songs	___ $ 12
Outdoor Adventure with
Wilderness Inquiry	___ $ 19
Pickleball
Sep 11	___ $ 12
Oct 16	___ $ 12
Pinecone Decor	___ $ 15
Pool Party!	___ $ 15
Project Power Bowling Invitational	___ $ 24
Quick Lasagna	___ $ 19
Rice Krispie Treat Pumpkins	___ $ 19
Rhythm and Bells	___ $ 49
Table Tennis	___ $ 15
Thanksgiving Dinner	___ $ 19
Water Aerobics
Oct 10	___ $ 15
Nov 7	___ $ 15
Wood Slice Ornament	___ $ 22

Participant total: $ __________ Staff / Caregiver total: $ __________

Paper check: Payable to“ Anoka-Hennepin Schools”( All checks are processed electonically.)

Credit card: Name:__________________________________________ Card No.:____________- ____________- ____________- ___________ Exp. date: _________ / _________

UCare Healthy Benefits Card No.: ____________- ____________- ____________- ___________ Exp. date: _________ / _________

Zumba Moving and Grooving
Sep 19	___ $ 15
Oct 17	___ $ 15
Nov 14	___ $ 15

COMMUNITY INCLUSION ACTIVITIES
Holiday Inclusion Bowling Night	___ $ 24
Inclusion Hayride and Bonfire	___ $ 22
Inclusion Pickleball	___ $ 12
Paint Your Friend	___ $ 22

STAFF / CAREGIVER REGISTRATION
Anoka Middle School Play		___ $ 15
Breakfast for Dinner		___ $ 19( if eating)
Candy Molds		___ $ 19( if eating)
Dinner and Treats at DQ
Sep 23		___ $ 15( if eating)
Cheeseburger	Hot dog		Chick. strip
Oct 13		___ $ 15( if eating)
Cheeseburger	Hot dog		Chick. strip
Dinner Sammy’ s Pizza
Oct 1		___ $ 25( if eating)
Dec 9		___ $ 25( if eating)
Fall Social – Root Beer Floats ___ $ 5( if eating)
Grand Slam		___ $ 24( if participating)
Halloween Dance		___ $ 12( if eating)
Hayride and Bonfire		___ $ 22
Holiday Dance		___ $ 12( if eating)
Holiday Sugar Cookies		___ $ 19( if eating)
Inclusion Hayride and Bonfire ___ $ 22
Movie and Taco Night		___ $ 20( if eating)
Movie and Pizza Night		___ $ 20( if eating)
Movie and Sub Night		___ $ 20( if eating)
Quick Lasagna		___ $ 19( if eating)
Rice Krispie Treat Pumpkins ___ $ 19( if eating)
Thanksgiving Dinner		___ $ 19( if eating)

Mail form and payment to Anoka-Hennepin Community Ed. Attn: Project Power 2727 N. Ferry St., Anoka, MN 55303

or FAX form to 763-506-1299 and call to make payment at 763-506-1290

or easy online registration and payment option. Go to ahschools. ce. eleyo. com

Community Education - current class catalogs Project Power - Fall 2025 | Page 15

FALL 2025 registration form