American Red Cross
Babysitter’s
Training
Where: Deerfield Public Library
When: Thursday, March 27, 2008
Times: 9:00-4:00pm
Ages: 11 to 15
Cost: $55.00 per person
Registration Deadline: Friday, March 21, 2008
*** Registration is limited to 12 students. (First Come First Serve)
Participant Name _________________________________________________________________
Date of Birth Age Grade _____________
Mailing Address City Zip ________
Parent/Guardian(s) Name ___________________________________________________________
Home Phone Work Phone __________________________
Medical Concerns/Allergies _________________________________________________________
Emergency Contact ________________________________ Phone _______________________
(in case the parent/guardian cannot be reached)
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IMPORTANT
Waiver of
Participation
Please read and sign the following
I,
the parent/guardian of the registrant, a minor, agree that the registrant
and I will abide by the rules of the
Printed
Name of Parent/Legal Guardian
Signature
Date
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Return form to the Deerfield Community Center, 3 W Deerfield St., Deerfield, WI 53531
For more information please contact Julie Schwenn at 764-5935.