2018 Registration

2018 Registration

2 Jul, 2018
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2018 Summer Experience Logo - RE-SEEDPlease complete the registration form below. Programming will be differentiated between scholars in entering grades 8 and below, and those entering 9th grade or higher, with a balance of character development, physical fitness activities, and leadership opportunities for all.

Student Name:*
Gender:*
Birthdate:*
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Height & Weight (approx.):*
Shirt Size:*
Home Address:*
Phone (Parent):*
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Phone (Student):
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E-mail:*
School Name (2016-17):*
Grade Level (2016-17):
School Name (2017-18):*
Interests/Hobbies/Gifts/Talents:*
Previous Sports or Extracurricular Activities Participated in:
If other specified above, please provide details:
Which of the following mini-academies would you be interested in?:
Any Allergies or health concerns? If yes, please describe
Health Insurance/Doctor Info:
Would you like to support our program?:*
If yes, please indicate your desired form of support. Some options are listed below, but we welcome ANY additional methods of support you may have to offer. (Donation of items - snacks water, classroom materials (pencils/paper/binders), fitness equipment; Volunteer (During our daily program (leading a workshop, filming/photographing, reading, coaching, or general supervision) or as a chaperone for a field trip); monetary donation (to support our student leadership program (stipends, training materials), field trips)
Do you give authorization for photos/videos of your child to be taken and used for the purposes of marketing the TCG Memorial Academy and its activities? *
I, as parent/guardian, understand that by permitting my child to participate in this club, I have waived all claims against the organizers, the TCG Memorial Academy and its non-profit sponsors, for injury, accident, illness or death occurring during or by reason of participation in this activity.*
Parent Name (Electronic Signature) This will serve as your electronic signature confirming your child's participation in our program:*
Today's Date (To confirm your signature):