JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023-2024 Programs for Children and Teens Registration Form
Please complete this form in its entirety. Begin by providing information about yourself, the adult who is filling out this form.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Your Full Name
*
Your answer
Your Pronouns
She/her/hers
He/him/his
They/them/theirs
Xe/xem/xyrs
Ze/hir/hirs
Other:
Your Relationship to the Child(ren)
*
Custodial Parent
Non-Custodial Parent
Step-Parent
Legal Guardian
Foster Parent
Other:
Required
Your Full Address
*
Your answer
Your Email
*
Please provide an address that you will check frequently for RE information. Email is our primary method of communication with families.
Your answer
Primary Phone Number (please indicate home, work, or cell)
*
Your answer
Can You Receive Texts at the Above Number?
Choose
Yes
No
Preferred Method of Contact
Email
Phone Calls
Texts
Other:
Is There Another Parent/Guardian?
*
Yes
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
