Sparks & Feed The Fire Registration

Parent/Guardian Full Name *

Parent/Guardian Phone *

Parent/Guardian Email *

Feed The Fire & Sparks Program Dates:

Weeks: Sept 27, Oct 4, Oct 18, Oct 25, Nov 1, Nov 8, Nov 15, ]Nov 22, Skipped: Oct 11 (Thanksgiving Weekend)

Sparks Session Selection *

Sparks - Session 1 - 9:30AM Start

Sparks - Session 2 - 10:45AM Start

Feed The Fire Session Selection

FTF Session 1 - 9:30 Start

FTF Session 2 - 10:45 Start

Date of birth *

Medical Concerns (ALLERGIES)

Athlete Gender: (SELECT ONE) *

female

male

Athlete Pronouns (SELECT ALL THAT APPLY) *

she/her

he/him

they/them

ze/zir

I have read and agree with both the terms of the Media Consent & Waiver and the Release of Liability statement.