2020 Winter Scouts Enrollment

Child to Enroll*

Please include a preferred name or nickname for child when applicable.

Child Information*

Date of Birth is required.

Date of Birth	Age (at beginning of semester)	Gender	School

Child's Home Address*

Street Address City State ZIP Code

Home Phone*

Parents / Guardians*

To add additional parents or guardians, click the plus sign on the right. At least 1 phone number is REQUIRED for each person.

Name	Relationship	Phone, Work	Phone, Cell

Parent/Guardian 1 Email*

Mtn SOL communicates with parents/guardians primarily through email. At least 1 email is required.

Parent/Guardian 2 Email

Photo/Video Permissions*

Please check one of the following:

I hereby grant permission for my child to be included in evaluation and photographic pictures, including video/audio recordings, connected with the afterschool program.
Check here if you permit your child to be in photos and videos, but not the use of his/her name.
Check here if you do NOT grant permission for your child to appear in any photographs, video or audio recordings.

Emergency Form

A complete and updated emergency form must be on file with Mountain SOL prior to attending afterschool programs (see Emergency Contact form for additional details.)

I will submit a completed and updated emergency form.

Parent/Guardian Signature*

By typing your name and clicking the submit button it constitutes a legally binding signature just like a handwritten one.

Today's Date*

2020 Winter Scouts Enrollment

2020 Winter Scouts

Step 1 of 2

2020 Winter Scout Enrollment

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