Forms • City of San Benito Keep San Benito Beautiful: Sprout

City of San Benito Keep San Benito Beautiful: Sprout Scouts Summer Program Registration

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Child’s Full Name*
Child's Date of Birth*
Child's Age*
Child's Grade Level
Parent's Name*
Parent's Phone Number*
Parent's Email Address*
Home Address*
Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Phone Number*
Does child have allergies (food, plants, insects)?*
My child may participate in all activities.*
My child may receive emergency medical care.*
I give permission for my child to participate in media activities, including video recording and photography.*
Does your child have medical conditions / special needs?
Student's t-shirt size*
(Kids may answer.) Do you like planting flowers, fruits, or vegetables?
(Kids may answer.) Have you ever planted anything before?
(Kids may answer.) Where would you like to plant?
(Kids may answer. Do you like being outside in nature?)
(Kids may answer.) What do you like most?
(Kids may answer.) Do you want to learn about recycling and keeping our community clean?
(Kids may answer.) What does “taking care of the Earth” mean to you? What are you most excited to do in Sprout Scouts?
For Parent: By typing my name below, I certify that the information provided on this form is accurate.*
Today's date*

* indicates required fields.