SUMMER 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 ___________________

Anoka Aquatic Center					___ $ 14
AMSA Play – Beauty and the Beast					___ $ 15
Back to the 50s Elvis Event					___ $ 15
Bingo
May 13					___ $ 11
May 27					___ $ 11
June 18					___ $ 11
July 29					___ $ 11
August 13					___ $ 11
Bowling League
June 9- 30					___ $ 65
July 7- 28					___ $ 65
Churros					___ $ 19
Crafty Artists Art Night!
June 25					___ $ 9
August 21					___ $ 9
Dessert in the Park					___ $ 12
Dinner Sammy’ s Pizza
June 24					___ $ 25
August 26					___ $ 25
Dinner and Treats at DQ
June 10				___ $ 15
Cheeseburger		Hot dog		Chick. strip
July 15				___ $ 15
Cheeseburger		Hot dog		Chick. strip
August 19				___ $ 15
Cheeseburger		Hot dog		Chick. strip
Dust Devil T-ball				___ $ 45
Small	Medium		Large		XXL

Egg Carton Art	___ $ 12
Feed My Starving Children	___ $ 9
Fire Station Tour	___ $ 9
Friday Night Bowling
May 16	___ $ 22
June 20	___ $ 22
July 18	___ $ 22
August 8	___ $ 22
Grazing Horse	___ $ 22
Ham and Cheese Sliders	___ $ 19
Hawaiian Bowling Night	___ $ 22
Kickball	___ $ 35
Lilli Putt	___ $ 22
May Day Baskets	___ $ 12
Mixed Media Art	___ $ 18
Mother’ s Day Gift –
Essential Oil Diffuser	___ $ 15
Movie and Pizza	___ $ 19
Music with Claire	___ $ 12
Origami	___ $ 12
Performance in the Park –
The Backyard Band	___ $ 9
The Percolators	___ $ 9
Sea Shell Crafts	___ $ 12
S’ mores Bars	___ $ 19
Spring Dance	___ $ 15
Superhero Bowling Night _	___ $ 22
Table Tennis	___ $ 14
Unda Da Sea	___ $ 22

Walking Tacos ___ $ 19 Staff / Caregiver Registration

AMSA Play – Beauty and the Beast			___ $ 15
Back to the 50s Elvis Event			___ $ 15
Churros		___ $ 19( if eating)
Dessert in the Park		___ $ 4( if eating)
Dinner Sammy’ s Pizza
June 24		___ $ 25( if eating)
August 26		___ $ 25( if eating)
Dinner and Treats at DQ
June 10		___ $ 12( if eating)
Cheeseburger	Hot dog		Chick. strip
July 15		___ $ 12( if eating)
Cheeseburger	Hot dog		Chick. strip
August 19		___ $ 12( if eating)
Cheeseburger	Hot dog		Chick. strip
Feed My Starving Children		___ free
Ham and Cheese Sliders		___ $ 19( if eating)
Lilli Putt		___ $ 19( if golfing)
Movie and Pizza		___ $ 15( if eating)
S’ mores Bars		___ $ 19( if eating)
Spring Dance		___ $ 9( if eating)
Walking Tacos		___ $ 19( if eating)
Registering for the TWINS PREGAME / GAME
Call 763-506-1290, Deadline is May 5, before 4 pm.
$ 25 each person, one chaperone per person, required.

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.

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: _________ / _________

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 -Summer 2025 | Page 15

SUMMER 2025 registration form