Baltimore County Connect Program Registration Fall 2019

Join IMAGE in Baltimore County for session activities designed to build opportunities for increased skills related to money management, social and communication skills and time management. Register today!

Tuesdays from 5:30-7:30pm
Session Locations TBD (Centrally located in Towson and Baltimore County)

August 27th
September 10th
September 24th
October 8th
October 22nd

*Program fee $80.00
*There may be additional cost including food, drink or any other additional outing fee.

ALL REGISTRANTS~ To begin registration please complete the questions below and review the program goals for the summer session by clicking each goal and typing your digital signature at the bottom.

*NEW IMAGE YOUTH PROGRAM PARTICIPANTS ONLY!!!! After completing this registration you will need to follow the link at the bottom of this form. The link will take you to a general intake form that will also need to be completed in order to fulfil your registration. *This is only for registrants who have never participated in IMAGE youth programs and have not yet completed a general intake in the past*

Email address *
Participants Name *
Your answer
Date of Birth *
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Parents Name: *
Your answer
Emergency Contact Number *
Your answer
What should we know about this registrant for this session? (Allergies? Medical Concerns? Behavioral Concerns?) *
Your answer
Session Goals: Please check off each as you read them. *
Required
Date of Signature: *
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ALL PARTICIPANTS!!!! Please copy and paste the link below in order to complete your registration and make payment. http://events.constantcontact.com/register/event?llr=efc5pihab&oeidk=a07egikdjbh9c0788f9
Your answer
*NEW REGISTRANTS ONLY! IF YOU ARE NEW TO IMAGE PROGRAMS PLEASE CLICK THE LINK BELOW TO FINISH YOUR REGISTRATION. https://docs.google.com/forms/d/e/1FAIpQLSdhJJmELcLr4N9sEG7g3Tlc47vTCJkmTxsTo7X6iDoze8Ofww/viewform?usp=sf_link
Your answer
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