ROBC Youth Group Enrollment

2020-2021 ROBC Youth Group Enrollment Form
ROBC Youth Group is ready for youth to be registered into the YG Program!! Please register your youth by filling out the information below. A separate form will need to be completed for each individual youth you are enrolling. If you have any questions or concerns, please contact Taisia Alagoz at 503-910-2439, or Stephanie Ayhan at 503-881-2969.
Youth's Name
First Last
Gender
- Female
- Male
Date of Birth
MM slash DD slash YYYY
Current Grade/Age Group
I give permission for my youth to be photographed for promotional purposes, including print and social media uses:
- Yes
- No
Parents Name
First Last
Parent Email
Parents Phone
Secondary Phone
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing Address (if different than above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

2020-2021 ROBC Youth Group Enrollment Form