Teen Group Signup Form - Lakes Region Community Services

Teen Social Group Signup Form

Program to Attend(Required)

Name of Teen Attending(Required)

First Last

Age(Required)

Name of Parent / Guardian(Required)

Please note, this is not a drop-off group. Parents and guardians are always welcome to stay in the room with us, but can choose to stay in the lobby instead.

First Last

Email to contact for any program changes

Phone (if no email) to contact for any program changes