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  • Type/Date of event:  Summer Stretch 2019

    August 5th
    August 6th
    August 7th - Valleyfair day
    August 8th

              August 9th - half day 
    
    Individual(s) in charge:  John Boyle, Zach Zaldivar
    
    Transportation: Bus
    
    Cost of event: 

    $195.00 (Jr. High Participant)
    $115 (Sr. High Leader)
     

    Note: This is a fixed cost for the program regardless of the number of events participants attend.
    (Scholarships are available. Contact John Boyle [johnboyle@saintvdp.org] for information.)

    
     

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  • 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 AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY 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.
    • Parent Chaperone
      
      A parent/adult (21+) is required to volunteer 2 shifts for valid Jr High registration
       

      Morning Shifts:      8:30AM - Noon
      Afternoon Shifts: 12:30PM - 4:30PM
    • Shift Preference REQUIRED (Select One) One all day shift Two half day shifts No preference Please fill out this field.
    • Availability August 5th - Morning  August 5th - Afternoon  August 5th - All Day (counts as two shifts) August 6th - Morning August 6th - Afternoon August 6th - All Day (counts as two shifts) August 7th - All Day (counts as two shifts) August 8th - Morning August 8th - Afternoon August 8th - All Day (counts as two shifts) August 9th - Morning

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  • • Number of Jr. High Participants to Register REQUIRED Please fill out this field.
    • Jr. High Participant 1
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Teen Attending August 5th August 6th August 7th August 8th August 9th
      • Participant Fee195.0

    • Jr. High Participant 2
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Teen Attending August 5th August 6th August 7th August 8th August 9th
      • Participant Fee195.0

    • Jr. High Participant 3
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Teen Attending August 5th August 6th August 7th August 8th August 9th
      • Participant Fee195.0

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  • • Number of Sr. High Leaders to Register REQUIRED Please fill out this field.
    • Sr. High Leader 1
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Leader Attending August 5th August 6th August 7th August 8th August 9th
      • Leader Fee115.0

    • Sr. High Leader 2
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Leader Attending August 5th August 6th August 7th August 8th August 9th
      • Leader Fee115.0

    • Sr. High Leader 3
      • First Name REQUIRED Please fill out this field. Please enter valid data.

        Last Name REQUIRED Please fill out this field. Please enter valid data.
      • Previous School Year Grade REQUIRED Please fill out this field. Please enter valid data.
      • Gender REQUIRED Male Female Please fill out this field.
      • T-Shirt (Adult sizes) REQUIRED (Select One) Small Medium Large XL XXL XXXL Please fill out this field.
      • Dates Leader Attending August 5th August 6th August 7th August 8th August 9th
      • Leader Fee115.0

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  Total:

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