Summer Recreation 2018
Welcome to the Summer Recreation program! Thank you for registering! If you have any questions or concerns, please email me: vicki.radzak@isd97.org or call 485-4435 ext. 1062.
Email address *
Student Name *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Email *
Your answer
Township of residence *
Your answer
Parent/Guardian Cell,Work & Home #'s *
Your answer
Emergency Contact Name & # *
Your answer
Activity #1
Your answer
Activity #2
Your answer
Activity #3
Your answer
Activity #4
Your answer
T-Shirt Size If Applicable
Your answer
Swimming Level if Applicable
Your answer
Special Needs, etc.? *
Your answer
I give permission for my child to participate in the Moose Lake Community Education's Summer Recreation Program. By checking the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Required
Would you like to be on the Moose Lake Community Ed. electronic mailing list? We advertise classes via emails a few times a month and it's in a lovely format.
A copy of your responses will be emailed to the address you provided.
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