Teen Night w/ Morgan Foley: Registration
Participant Information
Young Adult Name
*
First Name
Last Name
Age
*
Recommended for teens aged 15-19
Gender
Male
Female
Non-binary
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell us about you (e.g. favorite activities, special interests, things you love, things you don't like, etc.)
Will you need accommodations for this event?
*
Yes
No
If you answered yes to the above, please let us know what we can provide to make sure that you have a good experience.
Parent/Guardian Information
Name
*
First Name
Last Name
Cell Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name
*
First Name
Last Name
Relationship
*
Please Select
Mother
Father
Grandparent
Aunt or Uncle
Caregiver
Family Friend
Babysitter/Nanny
Phone Number
*
My Products
*
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Teen Night: 3 weeks
Program Dates (every other Friday): May 10, May 24, June 7, June 21
$
60.00
Credit Card
Submit
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