Clone of Pelican Lake July 15th, 2026

Stearns County Water Safety Class

July 29th, 2026, Shady's Long Shots, Horseshoe Chain
Please complete a separate form for every student attending
Student Name*

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Parent / Guardian *

First NameLast Name
Parent / Guardian Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Parent / Guardian Phone
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Stearns County Water Safety Class