Eaton Summer Registration
2017 Eaton Summer Club Registration
Open May 30th – July 28th

Closed – May 29th & June 5th- June 9th Closed July 4th

Open 7:30 – 5:30
Participant's Full Name: *
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Date of Birth: *
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Age: *
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Member #:
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Gender: *
2017 - 2018 School Year Grade: *
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Current School: *
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Current Lunch Status: *
Name of Parent / Guardian: *
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Street Address: *
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City: *
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Zip Code: *
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Cell / Home Phone: *
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Alternative Daytime Phone:
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E-mail Address:
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Additional Child
Full Name:
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Member #:
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Gender:
Date of Birth:
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Age:
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Current School:
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2017 - 2018 School Year Grade:
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Additional Child 2
Full Name:
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Member #:
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Gender:
Date of Birth
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Age:
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Current School:
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2017 - 2018 School Year Grade:
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By printing my name below, I acknowledge that the information I provided is correct to the best of my ability.
Parent / Guardian Name: *
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Date: *
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