Community Education - current class catalogs Project Power - Spring 2016 | Page 15
Spring 2016 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
REQUIRED - Legal guardian/emergency contact:
Day
Year
Guardian name: ________________________________________________ Phone: ____________________________
Sports & exercise
Laugh &
learn
Out & about
Cooking
& dining
Arts &
crafts
Emergency contact: ____________________________________________ Phone: ____________________________
(Emergency contact must be able to be reached during class t [YK