Rockford Community Education Youth Registration Form
**Please do not use this form to register for Rocket Power or 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
Submit
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