LET'S READ REGISTRATION
“LET’S READ” SUMMER TUESDAYS
FOR YOUTH
Includes those entering 7th-9th grades
Tuesdays: June 9 – August 11, 1:00-3:00 PM
Reading & Recreation
Fee: $45.00
NAME: ________________________________________________GRADE IN FALL: ___________
PRIMARY MAILING ADDRESS:
________________________________________________________________________________
PRIMARY FAMILY EMAIL: __________________________________________________________
FATHER’S NAME: _______________________________ PHONE #_________________________
MOTHER’S NAME _______________________________ PHONE # _________________________
EMERGENCY CONTACT INFORMATION:
NAME:_________________________________________ PHONE #_________________________
PARENT SIGNATURE: ____________________________________ DATE: __________________
Notes: (allergies, etc) _________________________________________________
_______________________________________
SNACKS