Youth Track Registration | National Federation of the Blind of Arizona

Youth Track Registration Form, Please Fill Out All Rrequired Fields.

Parent/Guardian Name

Additional Parent/Guardian Name

Mobile Phone Number

Additional Mobile Phone Number

Email Address

Additional Person Who May Check Child Out of Kids Track Program

Child's Name

Additional Child's Name 2

Additional Child's Name 3

Additional Child's Name 4

Permission to Change my Child’s Diaper if Needed

Yes

Permission to Change my Child’s Diaper if NeededPermission to Transport my Child to the Phoenix Children’s Museum on Sunday, August 27th. (Return by noon).

Permission to Transport my Child to the Phoenix Children’s Museum on Sunday, August 27th. (Return by noon).

Yes

Please List Any Allergies, Additional Health Issues, or Any Other Concerns

I Understand That It Is My Responsibility to Administer Any Medication To My Child During Youth Track Activity Hours. I Agree I Wish to Enroll My Child In The 2023 NFBAZ State Convention Youth Track, and Give My Child Permission to Participate in The Related Activities. Please Enter Your Initials As Your Signature

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