SUMMER 2014 (Forms Avaliable Below)

OPEN REGISTRATION BEGINS, MARCH 3rd, 2013

• Ø Complete Registration Form & Emergency Contact Sheet,for EVERY participant.
• Ø Please Print all information, and make certain it is accurate.
• Ø Return: Completed Registration Form & Emergency Contact Form, Check and/or Money Order:      ***Payable to: FPCHS***

Mail or Deliver To:  Flagler County Youth Center

                                                5500 East Highway

                                                Palm Coast, Fl 32164

                                               (Youth Center: Open M-F, School Days, from 2:00pm -7:00pm.)

Registration Fees: 1st Camper: $150. Every additional family member, add $125.

• Ø Additional Photo-Copies can be made of this application, to register other children. 1 form is required for EVERY child.
• Ø Please include a photocopy of one parents/guardians most recent Florida Drivers License. 
• Ø New participants to the program are required to provide a copy of their Birth Certificate.
• Ø Call: 386-437-7540X5101, for additional information.

Any questions please email me at [email protected]