December 21st Skating and Swimming Application!

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Apply for our December 21st skating and swimming day! We'll go toApex down in Arvada. Drop off will be at TEENS, Inc. at 10:30 am and pickup will be 3:30 pm. Please call us at 303.258.3821 if you have any questions. You can also email ian@teensinc.org. Your application does not guarantee a spot. Please do not make plans to participate until we contact you.

Participant name *

Participant Age *

Participant Email *

Parent or Guardian Name *

Parent or Guardian Email *

Parent or Guardian Phone # *

Our program is limited to ten participants. So please take the time to share with us why you think you would be a valuable member of our team? *

Why do you want to participate in this program, and what are you most excited to learn, do, or try? *

The cost of the program is $40 and TEENS, Inc. operates on a sliding scale. Please let us know how much you can contribute below (it will not affect your ability to participate in the the program). *

I can pay $65 ($25 towards Outdoor Leadership scholarships.)

I can pay the full $40

I can pay $30

I can pay $20

I can pay $10

I need a full scholarship

Other:

You will need to complete the med form and waiver, which we will send you digitally (or pick up a copy at TEENS, Inc. ) and have it completed by the first day of your session. Are you able to do this? *

Yes

Other:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of TEENS, Inc.. Report Abuse

Forms