Sign up form for children and youth activities Child's Name * First Name Last Name Child's date of birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Contact Name * First Name Last Name Your relationship to the child? * Phone * (###) ### #### 2nd Phone (###) ### #### Does your child have any medical conditions? * Does your child have any allergies? * In the event of an emergency all effort will be made to contact you, if we are unable to, do you consent for us seek/administer emergency medical treatment? * Yes No Thank you!
