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Strengthening Families Registration

Applications are accepted on a first-come, first-serve basis. The rules for acceptance and participation are the same for everyone, without regard to race, color, religion, or national origin.

Please choose from the following class options:

Class #1. Wednesdays beginning April 8, 2015 - June 10, 2015 for families with children ages 6-11

Class #2. Mondays beginning March 30, 2015 - June 8, 2015 for families with youth ages 12-17

Class Dates(*)

Class #1 Wednesdays April 8, 2015 - June 10, 2015Class #2 Mondays March 30, 2015 - June 8, 2015
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PARENT INFO

Parent 1(*)
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Parent 2
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Address(*)
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City(*)
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State(*)
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Zip(*)
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Home Phone(*)
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Work Phone(*)
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Email Address(*)
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CHILD INFO

Child Name 1(*)
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Child 1 Age(*)
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Child 1 Sex(*)

FemaleMale
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Child Name 2
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Child 2 Age
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Child 2 Sex

FemaleMale
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I have additional children to add.(*)
Yes.No, my list is complete.
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Child Name 3
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Child 3 Age
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Child 3 Sex

FemaleMale
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Child Name 4
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Child 4 Age
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Child 4 Sex

FemaleMale
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Child Name 5
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Child 5 Age
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Child 5 Sex

FemaleMale
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By clicking "Submit," I agree that my child (or children) indicated above may participate with the South Salt Lake Coalition for Drug Free Youth.