Program Registration Thank you for taking interest in our program! Please give us little information about you and we will get back to you right away! Contact Name * Please give us first and last name of the person we will be contacting if there is changes to this program. (Parent, Guardian, Adult participant etc.) Participant(s) Name and Age (if under 16) * Please give us the participant's name and age. If there is more than one participant please separate with a ; (example: Dorothy Gale- 15; Matilda Wormwood -7; Valerie Fizzle) Phone number * E-mail address * Which program would you like to sign up? * Family Story-time June 9th 10:30am (ages 5 and under) WAIT LIST Family Story-time June 16th ( you will recieve an E-mail Thursday June 15th if a Space opens) Family Story-time June 23rd 10:30am (ages 5 and under) Family Story-time June 30th 10:30am (ages 5 and under) Cardboard Go Cart Challenge Pick up supplies before June 17th Present go cart June 24th Other information Use this space freely to either ask us a question regarding program(s) that you are signing up for or give us information, how many participants in each program. Leave Blank
Thank you for taking interest in our program! Please give us little information about you and we will get back to you right away!
