Clone of Chillin' and Reelin' Ice Fishing Registration Form

May 2nd 2026 Mushroom Foray Registration Form

SPARK Explores Expeditions are for students in 6th through 12th grade for academic school year 2025/26. Space is limited to 15 participants.
Parent/GuardianYouth (please note parental permission is required in order to participate)Other

Participant (Youth) Information
Participant's (Youth) Name*

First NameLast Name
Participant's (Youth) Date of Birth

MonthDayYear
Date
Particpant's (Youth) school attending (City, West, CCA, etc.)*
6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th Grade
Particpant (Youth) Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant (Youth) phone number #
Please enter a valid phone number.Format: (000) 000-0000.
YesNo

Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Parent/ Guardian Phone Number #*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email*
Parent/Guardian Address (complete if different than the address provided for youth)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I give permission for my youth's participation in this SPARK program, and for United Action for Youth (UAY) to transport them to/from the program. I understand that a typed name in the box below functions as a legal signature.
Parent/guardian signature (please type name)*
After you click "Submit" at the end of this registration, you will be redirected to the Health, Safety, & Liability Waiver. This must be completed for your teen to attend the ice fishing outing.
Should be Empty:

May 2nd 2026 Mushroom Foray Registration Form