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:
MM
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DD
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YYYY
Age:
Your answer
Current School:
Your answer
2017 - 2018 School Year Grade:
Your answer
Additional Child 2
Full Name:
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Member #:
Your answer
Gender:
Date of Birth
MM
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DD
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YYYY
Age:
Your answer
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:
MM
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