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2. Instructions
   Please fill out all of the information as best as possible.
6. Participants Full Name *
8. Address
9. City, State, Zip Code
11. Parents Name*
12. Parents Phone Number*
14. Email address
15. Sign up*

    Please sign my child up for the TEEN RAD class starting December 27, 2019.

    1. Yes
    2. No
17. Parent/Legal Guardian permission needed*

    I understand that my child cannot participate in this program unless a permission slip is signed.

    1. I understand.
19. Info:
    Permission slips can be filled out in the Public Safety building. Please see Jessica during business hours (Monday-Friday 7:30 am - 4 pm) to get one. Please call 889-6922 if other arrangements need to be made.
21. Any Questions?
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit Submit and Print

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