Highland Grove Youth Center Reservation Form
Please Only Reserve One Time Slot Per Day
Additional Time Can Be Granted Based On Availability The Day Of
Email address *
First Name *
Last Name *
Emergency Contact (Name & #) *
Is your student in Elementary or Middle School? *
If Elementary, what school?
If Middle, what school?
***CAPACITY LIMITED FOR SIGN UP***
Due to social distancing, Highland Grove Youth Center allows on a set amount of kids in the building at a time. Please sign up for a time slot below for the day you wish to drop in to the facility. If capacity is not reached during the second session and your student is here for the first session, they will be permitted to stay but we cannot promise the full three hours.
Monday April 12th
Tuesday April 13th
Wednesday April 14th
Thursday April 15th
Friday April 16th
Monday April 19th
Tuesday April 20th
Wednesday April 21st
Thursday April 22nd
Friday April 23rd
A copy of your responses will be emailed to the address you provided.
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