Summer Stretch Registration

Type/Date of event: Summer Stretch 2017

July 17 ^th
July 19 ^th
July 24 ^th
July 26 ^th
July 31 ^st
August 2 ^nd

Individual(s) in charge: Kelly Hayes

Transportation: Car

Cost of event:

$165.00 (Jr. High Participant)
$70 (Sr. High Leader)

Note: This is a fixed cost for the program regardless of the number of events participants attend.

Household

Parent/Guardian Name REQUIRED Please fill out this field. Please enter valid data.
Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number REQUIRED Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Number of seat belts in family vehicle = driver + Please enter an integer (number).
Parent Chaperone

A parent/adult (21+) is required to volunteer 2 shifts for valid Jr High registration

Morning Shifts: 7:45AM - Noon
Afternoon Shifts: 12:30PM - 4:30PM
Shift Preference REQUIRED Please fill out this field.
Availability July 17th - Morning Driver July 17th - Afternoon Driver July 19th - All Day Chaperone (counts as 2 shifts) July 24th - Morning Driver July 24th - Afternoon Driver July 26th - Morning Driver July 26th - Afternoon Driver July 31st - Morning Driver July 31st - Afternoon Driver August 2nd - All Day Chaperone (counts as 2 shifts)