NOTE: Due to Data Privacy and Security requirements, all accounts must have a unique combination of Home Phone and Password.

General Information Each participant must have his/her own individual account created. Please make sure to setup all family members before completing registration. You must select the proper participant at the time of registration.     * Indicates Required Information * Home Phone:  (Enter Only Numbers, Including Area Code)   Work Phone: * First Name:    Middle Name: * Last Name:    Gender:   Male Female Disabled   Birth Date:   Age Group:   Age 0-5 Age 6-18 Age 19-54 Age 55+ * E-mail Address:    Registration confirmations and payment receipts are automatically sent when an e-mail address is provided. Your e-mail address will not be provided to any outside organization and is used only to send messages to you regarding program offerings and your account.   Check here if you choose not to receive email Marketing announcements. You will continue to receive email confirmations.

Address Information * Address:    * City:    Municipality:                           Ann Arbor Brighton Brighton Township CITY OF FENTON Cohoctah Commerce Twp Conway Township Dexter Fenton Township Fowerville Genoa Genoa Twp. Green Oak Township Hamburg Hamburg Township handy HARTLAND Holly Howell Howell Township Iosco Township Lyon Twp Marion Township Miford Milford Northfield Northport - Leelanau Northville Oceola Township Other Pinckney San Diego South Lyon washtenaw Whitmore Lake Wixom A new municipality entered will replace a drop-down selection. * State:  AL AK AZ AR CA CO CT DE DC FL GA GU HI IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY * Zip Code:    Resident:   Resident Non-Resident  (Within School District)

Contact Information (If Participant is Under 18) For many programs, additional information is required. Please provide as much information as possible. For children under the age of 18, the following information is required.   Emergency Phone:   Parent Name:   Home Phone:   Work Phone:   Cellular:   Pager:   Parent Name:   Home Phone:   Work Phone:   Cellular:   Pager:   Emergency Contact:   Grade:   Pre-Kindergarten Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12   In School Year: 2008 - 2009 2009 - 2010 2010 - 2011 2011 - 2012 2012 - 2013 2013 - 2014 2014 - 2015 2015 - 2016 2016 - 2017 2017 - 2018   School: