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YGN Summer Program 2020
Please fill out this form so we have your information. Submitting this form is NOT an agreement of any sort, and does not bind you to any commitment. It is for informational purposes only.
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Father's Name (first)
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Your answer
Mother's Name (first)
*
Your answer
Child's Name (first and last)
*
Your answer
Father's phone Number
*
Your answer
Mother's phone Number
*
Your answer
What is the best number to reach you if we need to?
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Father's cell
Mother's cell
Email Address
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Please enter an email address where you can be reached to inform you of changes to the programming or upcoming trips/events. (This list is used EXCLUSIVELY for the summer program, and for not other promotional or other purposes)
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Who should we contact in case of an emergency, (Name, relationship, number) if we cannot reach parents?
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