Middle School Summer Registration 2018
Thank you for your interest in participating in our Middle School Youth N.O.W. summer program.

Our summer program is from June 25th- July 27th. Hours are from 9:30-5:30 p.m.

The application below includes questions that help us with gathering information in order to register you for our program.

If you have questions please feel free to contact us or stop by our administrative office:

31 Carr Street |Watsonville, CA| 95076
831-768-7998
www.youthnowcenter.org

Student First Name *
Your answer
Student Last Name *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Grade *
School *
Your answer
Parent/Guardian Name *
Your answer
Phone *
Your answer
Address *
Your answer
Weeks Attending *
Yes
No
Week 1: June 25th- June 29th
Week 2: July 2nd-July 6th
Week 3: July 9th-July 13th
Week 4: July 16th-July 20th
Week 5: July 23rd-July 27th
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