4-H Class

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4-H Class

Who: 1st-5th Students

Dilworth Class:
Tuesday’s—Oct. 22, 29 and November 5, 12, and 19 from 3:15—5 pm
DGF Middle School Room #225 (FAQ’s Room) - Pick up at door 1 at 5 pm

Glyndon Class:
Wednesday’s—Oct. 23, 30 and November 6, 13, and 20 from 3:15—5 pm - Pick up at door 1 at 5 pm
DGF High School Room #218 (FAQ’s Room) - Pick up in classroom

Fee: $30 per student, $50 per two in a family, $60 per three in a family

Class Size: Minimum of 12 or Maximum of 20 students at each site and is first come, first serve

COMPLETE ONE REGISTRATION PER STUDENT

Student First and Last Name *

Address *

City *

State *

Minnesota

North Dakota

Grade *

1st

2nd

3rd

4th

5th

Site Attending

Dilworth

Glyndon

Parent First and Last Name *

Parent Phone Number (xxx-xxx-xxxx)

Parent Email Address #1 *

Food Allergies (Note in the "other" section what food allergies your child has) *

None

Other:

Registration is not final until complete payment is made in full. How will your payment be made? *

SchoolPay

Check (Payable to DGF Schools and routed in envelope addressed to DGF Community Ed. Mailing address is 513 Parke Avenue, Glyndon, MN 56547)

Cash (Dropped off in the Community Ed Office in Glyndon)

Tuition Assistance Requested (Review the tuition assistance guidelines on the Community Ed webpage)

I give/do not give permission for photos or videotapes of my child to be reproduced for DGF or 4-H promotional or educational purposes. *

Yes, I give permission

No, I do not give permission

I, the undersigned, parent/guardian of the above name child assume responsibility in case of accidents, injury or lost or damaged personal items during the program’s duration. *

I agree

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