High School Registration

Opportunity is missed by most people because it is dressed in overalls and looks like work.
-Robert Frost

A Program of

ONLINE PROGRAM REGISTRATION FORM

Youthlinks, 420 Broadway, Rockland, ME 04841

For High School Students

* required fields

*Student Name: (first, last)	*Parent/Guardian Name: (first, last)

*School:	*Grade:

*Home Phone:	Parent Cell:	Student Cell:
	(if none, type "N/A")	(if none, type "N/A")

We send out reminders of program and also cancellation notices. What is the best way to contact you?

Home Phone listed above	Facebook Message
Student Cell listed above	Student Email listed above
Text Message on Student Cell listed above	Do not give me any reminders or cancellation notices

We are going green! Receive registration information and updates by providing your email below.

Parent Email:	Student Email:

*Address

*City	*State	*Zip code

Please sign up for programs below. Program space is limited. Registration is recommended by Friday, February 17th. After we receive your registration we will send a confirmation email. If you don't make it into an activity we will add you to the waiting list; we will call you if a space opens up.

Spring Session: March 5th - April 13th

Please check off your program selection:

Monday

Tuesday

Wednesday

Thursday

Friday

Homework Lounge

2:00-3:00

Snacks, Hot Drinks & Study

Rock Coast Rollers' Jeerleaders

2:30-4:30

Jeer, Cheer, and Cause a Scene!

Skatepark Project*

1:55

Homework Lounge

2:00-3:00

Snacks, Hot Drinks & Study

OHSE e-News*

1:55

Punk Rope

3:00-4:15

Recess meets boot camp

Rockland Radio*

2:30-4:30

Punk Rope

3:00-4:15

Recess meets boot camp

Canine Outdoor Adventure*

2:30-4:30

Youthlinks Leadership Team*

3:00-4:30

Once a month

Runs all school year

Recycle-A-Cycle*

2:30-4:30

Animal Volunteer Team*

3:00-4:30

Big Brothers, Big Sisters*

2:30-4:15

Runs all school year

Big Brothers, Big Sisters*

2:30-4:15

Runs all school year

Hunger Games*

2:30-4:30

Transportation home is available M-Th at 4:45pm

Note: Travel time takes 30-60 minutes

*Includes Community Service

Other High School Programs

Please check off your program selection:

Bigger, Faster, Stronger

Meets at OHSE Weight Room, Monday through Friday 2:30-4:00.

See Coach Moore for details.

Soup Kitchen Includes 4 hours of Community Service!

Meets at St. Peter's Episcopal Church (by Rec. Center and Library)

2nd Saturday of each month, 10:00-2:00
Prepare, Cook, and Serve a meal for the Soup Kitchen with Youthlinks! Let us know if you are interested in joining.

Youthlinks Student Volunteers Includes Community Service!

Be a role model and have fun volunteering with the middle school after-school programs. We need 1-2 volunteers each day. Volunteer for just one day a week or for several days. Volunteers must be approved. If interested, you will be asked to fill out an application and attend a volunteer training at Youthlinks before starting.

*By typing my name below, I am agreeing to adhere to the Youthlinks Expectations:

* Student Signature

* Date 00/00/0000