Schoharie County Youth Program Registration
Registration
Online Registration
Email Address:
Guardian First Name:
Guardian Last Name:
Youth First Name:
Youth Last Name:
Date of Birth:
Age:
Mailing Address:
Mailing City, State Zip:
Home Number:
Cell Phone:
Work Number:
Emergency Phone Number:
Referral Agency:
(if applicable)
Select Program:
- Select Program -
Jr. Adventure Summer Day Program
Girls Leadership Adventure Day Trips
Important Information:
Check the Trips Included in the Registration
Select the trips in the order of your youth's preference.
If you selected a trip and want to
unselected
it, click the check box again
to Deselect and remove it from the registration.
Selected Trips
