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TTCAS Youth Mentorship Program Registration
Hi families! It's time to register your kids for another awesome school year. Please fill out this form as accurately as you can and sign the waivers, please. Thanks for your support and friendship!
* Indicates required question
Email
*
Your email
Parent/Guardian Information
Parent/Guardian FULL Name
*
Your answer
Primary Phone Number
*
Your answer
2nd Parent/Guardian FULL Name
*
Your answer
Secondary Phone Number
*
Your answer
Secondary Email
*
Your answer
Emergency Contact Name
*
Needs to be other than yourself or parent/guardian 2
Your answer
Relation to Child(ren)
*
Needs to be other than yourself or parent/guardian 2
Your answer
Emergency Contact Phone Number
*
Needs to be other than yourself or parent/guardian 2
Your answer
Please list the FULL names of any other adults you approve to pick-up your child(ren) from our classes
*
Your answer
Is your family currently enrolled in our after school Youth Mentorship Program?
*
Yes
No
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