Youth Training Academy Registration
Fill our this form to register your child in WCDI's YTA
Date and Age Group
July 10, 2018 YTA 1 9 a.m. - 2:30 p.m. WCDI
July 17, 2018 YTA 2 9 a.m. - 2:30 p.m. WCDI
Student's First Name
Student's Last Name
Date of Birth
Grade in School
Parent or Guardian First Name
Parent or Guardian Last Name
Emergency Contact Phone Number
Student Pertinent Medical Information (allergies, medication, etc.)
Any additional info you would like us to know?
I understand in the event of an emergency my child will be rushed to Columbus Regional Hospital. WCDI will contact the parent or guardian if any issues arise by the emergency contact phone number.
A copy of your responses will be emailed to the address you provided.
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