2024-2025 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.
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Your Full Name *
Your Pronouns
Your Relationship to the Child(ren) *
Required
Your Full Address *
Your Email *
Please provide an address that you will check frequently for RE information. Email is our primary method of communication with families.
Primary Phone Number (please indicate home, work, or cell) *
Can You Receive Texts at the Above Number?
Preferred Method of Contact
Is There Another Parent/Guardian? *
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