SJLA Youth Participant Registration - Ages 13 - 16
Before completing your registration form, please be sure to read about program first at kitesnest.org/summer-2019

Name *
Name
Date of Birth
Date of Birth
Phone
Phone
Phone, email, facebook messenger, or other social media platform? Please include social media name(s).
Address, Apt Number, City, State, Zip Code
Section

THANK YOU for taking the time to complete this application! We will be in touch soon to confirm your enrollment in the program.