All youth must be accompanied by an adult chaperone.
First Name:  Last Name: 
Address:  City:   State:   zip: 
E-mail:  Group Name:  (Optional)
Phone: (Optional - required for entry into drawing for $250 savings bond.)
Shirt size:
Sm    M    L    XL    None
(If you wish to order a shirt for the adult chaperone please indicate size.)
PHOTO RELEASE: (optional): I consent to the use of my child's photo taken during this event by the organizations involved for their not-for-profit official use only.
Register additional attendee ($5.00 each)
Register as: Youth Adult
First Name:
Last Name:
Age on June 8th:
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To make a donation to help offset the cost of Youth Outdoor Day please indicate the amount below. Thank you!