2005 Programs and Activities Registration Form

Sioux Falls YWCA

YWCA Summer Program Sign Up Form

Please fill out the form below where "Program or Activity" describes the Camp, Activity, or Program for which you wish to register.

After you click the "Submit Registration" button, you will receive notification confirming your request has been sent.

** Mandatory fields are highlighted and preceded by an asterisk

Sioux Falls Summer Program & Sign up Form

*Program or Activity:

Program Information

*Program or Camp Name:		Date of Camp/Session:		Day:		Year:
Membership:		Membership Expiration Date:

Contact Information

*Child's First Name:		*Child's Last Name:
Child's School:		*Child's Birth Date:(i.e. 01-01-1980)
*Parent's First Name:		*Parent's Last Name:
*Email address:		Address:
City:		State:
Zip Code:		Home Phone Number:
Cell Phone #:		Work Phone Number:

Payment Information
Method of Payment :

Additional Information:

Click the SUBMIT button to send your Request. You will receive an email confirmation once your Registration Form is received. Once payment arrangements have been made, you will be fully registered. Please contact info@ywca-sf.org if you experience problems using this form.

Be sure to click the Submit button only once. A separate Registration Form will be entered each time the button is clicked.