Youth Program Registration Form: Beyond Class What was the "Order #" from your email confirmation? * If you have not completed the checkout process yet, please do that first. You'll then receive an email confirmation with the "Order #". First and last names of all children attending the program: * Birth dates of all children attending the program: * Name of Primary Guardian: * Cell phone number for Primary Guardian * Home phone number for Primary Guardian * If so, describe the medical concern(s): Email address for Primary Guardian Home address for Primary Guardian * Alternate Authorized Pick-Up Contact name * Alternate Authorized Pick-Up Contact phone number * Do any of the children attending the program have allergies? Yes No If so, describe the allergies and their severity: Do any of the children attending the program have any medical concerns we should be aware of? * Yes No Buddy Request name Buddy Request email address If so, describe the medical concern(s) Buddy Request phone number Is there any additional information you'd like to add? Do you want us to send a Buddy Request (Does your youth want to invite a friend to attend with them)? * Yes No How did you hear about The Dollar Detectives? If you are human, leave this field blank. Submit Δ
