Name: Mentee Garden Program
Start: 2025-04-16T08:00:00-04:00
End: 2025-04-16T10:00:00-04:00

Participant First Name*

Participant Last Name*

Participant DOB

Please list any allergies participant has*

Which School does Participant attend?

Email

Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent/Guardian Email*

Phone*

Name of individual picking up participant*

Emergency Contact Phone Number*

Emergency Contact Name*

I grant Tri-Town Youth Services permission to use my/my child’s image in photos or videos for promotional, educational, and outreach purposes, including print, digital, and social media. I understand no compensation will be provided, and I release Tri-Town Youth Services from any liability related to image use.*

Yes

No

Mentee Garden Program

April 16 @ 8:00 AM - 10:00 AM

Details

Register