Rockford Community Education Youth Registration Form
**Please do not use this form to register for Rocket Club Gymnastics**

Participant Last Name: *
Your answer
Participant First Name: *
Your answer
Parent Name(s) *
Your answer
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip: *
Your answer
Home phone: *
Your answer
Cell Phone: *
Your answer
Emergency Contact Phone Number: *
A phone number where someone can be reached in an emergecy in the event we are unable to reach you at the numbers listed above
Your answer
Email Address: *
Your answer
Community Ed Course Name: *
**Please note that you must Registered and paid 3 days before the start of any class to be fully registered for the class.** If it is less than 3 days before the start of the class, please call 763-477-4563 to see if the class is still open and if you can still register or to make arrangements for payment.
Your answer
Payment Selection: *
A link to complete your PaySchools payment is provided once your form has been submitted.
I am interested in coaching
Contact Name and number if interested in coaching
Your answer
Sport I will help coach
I hereby agree to allow myself or my child to participate in the above RCE activity. In consideration of accepting this registration, I hereby, for myself and heirs,wave any and all rights and claims for damages I may have against ISD 883 and its representatives for any and all injuries from whatever cause suffered by the above participant in the indicated activity. *
Required
Please complete the following if completing a youth sport registration *
Child Birth Date
MM
/
DD
/
YYYY
Child Gender *
Current School Grade (For summer registration, please put the Grade entering in fall) *
Homeroom Teacher (not required for summer registration)
Required for Rockford Students Only
Your answer
Child T-Shirt Size
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