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2024 Summer MAC Registration Form
Please complete all information below by May 10, 2024. There is a $35 non-refundable materials fee charge per child. Please do not include payments with the materials fee.
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* Indicates required question
Child's name (First and last):
*
Your answer
T-shirt size:
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X-Large
Adult 3X-Large
Adult 4X-Large
School attended in 2023-24:
*
Franklin Elementary
Johnson Elementary
Liberty Elementary
Moore Elementary
Poplar Grove Elementary
Freedom Intermediate
Freedom Middle
Poplar Grove Middle
Other:
Grade completed 2023-24:
*
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
Date of birth:
*
MM
/
DD
/
YYYY
Gender:
*
Male
Female
Has the child been enrolled in MAC previously? If so, where?
*
Your answer
Ethnicity (select one):
*
Hispanic
Not Hispanic, Latino or Spanish origin
Primary Parent/Guardian:
*
Your answer
Primary Parent/Guardian email:
*
Your answer
Primary Parent/Guardian home phone:
*
Your answer
Primary Parent/Guardian cell phone:
*
Your answer
Primary Parent/Guardian address:
*
Your answer
Primary Parent/Guardian zip code:
*
Your answer
Primary Parent/Guardian employer:
*
Your answer
Primary Parent/Guardian work phone:
*
Your answer
Secondary Parent/Guardian:
*
Your answer
Secondary Parent/Guardian email:
*
Your answer
Secondary Parent/Guardian home phone:
*
Your answer
Secondary Parent/Guardian cell phone:
*
Your answer
Secondary Parent/Guardian address:
*
Your answer
Secondary Parent/Guardian: zip code:
*
Your answer
Secondary Parent/Guardian employer:
*
Your answer
Secondary Parent/Guardian work phone:
*
Your answer
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