Military Children, Children's Charities, Youth Development, Community Building

Parent(s) Name:

Parent(s) Name:* Child(ren)'s Name: (place a comma after each child’s name)

Attending child's t-shirt size? (e.g. Youth Small, Adult Medium - place a comma after each child’s t-shirt size)

Parent(s) e-mail address

Phone Number: (parent’s cell phone number)

City/Zip Code (your current location)

Military (Active/Guard/Reserves/Retiree)

Please specify

About Name: size?

How many children will participate in the program?

What grade(s) in school is your child(ren)? (e.g. 2nd, 7th, 8th)

Child(ren)'s Age(s)

Event Sign-Up: If you wish to sign-up for an event waitlist (spell out specific event in the below “other” placement)

Please specify

Level of Interest

Month Separation Will Begin

Tell Us About Your Family

Military Families