Summer Stretch Registration Form
Summer Stretch is a summer ministry program for middle school youth in grades 5 – 8 and high school students in grades 9 – 12, during the 2018/19 school year.
Cost: $135.
Registration deadline: May 22, 2019.
Registration Instructions: Completed the following form and pay the $135 non-refundable fee and $40 Volunteer Buyout fee, if applicable, to a participating Church Office, or pay online at https://paypal.me/SummerStretch. A small processing fee will be added to all online credit or debit card payments. Checks are payable to Centennial Area Summer Stretch (CASS).
Financial aid is available – contact a Summer Stretch Coordinator for more information.
Email address *
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
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DD
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YYYY
Gender *
Participant or Youth Leader *
Student Cell Phone Number *
Your answer
Address *
Your answer
Parent(s) or Guardian(s) Name(s) *
Your answer
Home/Daytime Phone Number *
Your answer
Parent/Guardian Cell Phone Number *
Your answer
Parent/Guardian email address where you would like program information sent *
Your answer
Church Member at *
Your answer
Grade Completed Spring of, 2019 *
T-shirt size (Adult sizes) *
My son/daughter has my permission to participate in all Summer Stretch program activities from June 10 through June 14, 2019. Should a situation arise, I give the adult leaders permission to seek the necessary medical attention for my child. Summer Stretch reserves the right to use the above named person’s picture in any Summer Stretch publications or other media presentation. A "yes" response represents an electronic signature. *
Preferred Hospital or Clinic *
Your answer
Name of Insurance Provider & Policy Number *
Your answer
Allergies, medical or other concerns *
Your answer
Please select any days your child will NOT be attending Summer Stretch *
Required
Can I be with a friend? Students may request ONE friend to be in your same small group. Summer Stretch will do their best to accommodate the request. Youth Leader requests are not accepted. There is no switching once requests are made. Please include first and last name of friend and what grade they will complete spring of 2019.
Your answer
Making Summer Stretch Work: A parent (or other responsible adult 21 years or older) of each participant is required to help at Summer Stretch for one volunteer shift (Monday, Tuesday, Wednesday, Thursday mornings) or a full day (Friday). Youth Leader parents are encouraged to serve, but are not required. You will only be assigned to work one shift unless you indicate otherwise. Volunteers on Friday will spend the whole day with our Summer Stretch group. If you choose Friday, your afternoon activity fee will be covered by Summer Stretch. Volunteer times are as listed. Check all shifts you are available. *
Required
Volunteer Buyout Option: Because lives are busy and we know that volunteering is not an option for everyone, we are offering a $40.00 buyout for anyone who does not want to, or cannot, volunteer their required shift. Parents who do not volunteer their required shift during the summer will receive an email reminder of their volunteer buyout balance at the end of the Summer Stretch week. *
Key Adult Volunteers: Key Volunteers come each day and lead one specific area (e.g. assigning drivers, coordinate the Watershed District, bake and deliver cookies, represent Summer Stretch on a daily basis at one of our service sites, etc.). Being a Key Volunteer waives the fee for one participant or youth leader. If you are interested in more information, please contact a Summer Stretch Coordinator. *
I understand that my registration is not complete until I have paid $135, plus $40 for Volunteer Buyout, if applicable, to a participating Summer Stretch church or paid online. A small processing fee will be added to all online credit or debit card payments. Click here to pay online: (https://paypal.me/SummerStretch) *
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