CYS - REGISTRATION
Please fill out the information below to register for Community Youth Services Remote Learning Opportunity.  Any questions and/or concerns can be relayed to info@communityyouthservicesinc.org
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Student Name *
Student Age *
Parent/Guardian/Emergency Contact (Name, Phone, Email) *
What are you looking for? (Select all that apply)
Please select the days that you would like to attend *
Required
Please Select Time Slots *
Please Select all that apply...(This helps us to better plan for disinfecting and cleaning purposes - as well as ensuring adequate social distancing procedures).
Required
Questions/Comments
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