Summer Shakedown Interest Form

If you or a teen you know would like to participate in any of the summer programs  please fill out the form below. 

If a scholarship is needed please make sure to indicate YES on the scholarship question. 

This is merely an interest form to connect to the contact person and does not count as registration nor does it guarantee a space in a program. 
 

Please complete the form below

Name of Teen *
Name of Teen
Your name (if different from teen)
Your name (if different from teen)
Phone # of teen and/or guardian *
Phone # of teen and/or guardian
Please note only 1 scholarship per teen can be given. Please make selections of programs with this in mind.
Program(s) of interest *
Check all of interest