Harry Potter Retreat - youth registration
Please fill out this form and click submit.
Youth Name
*
Parent name
*
Parent Email
*
This address will receive a confirmation email
Parent Phone
*
Youth Phone
*
Youth Email
This address will receive a confirmation email
Please list any allergies (food or environmental)
*
Transportation
*
Please select all that apply.
I can offer a ride for another person
I need help with a ride
Option
Medications
*
Please select all that apply.
I will be bringing medication and need help administering
I will be bringing medication and will administer on my own
I have an Epipen
Please upload a copy of insurance card
*
Please upload a copy of signed permission slip
*
Submit
Description
Please fill out this form and click submit.
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