Test Note: One registration per form. If you are registering more than one youth, you will need to fill out this form again. After registering your first youth, just reload this page, select "registering additional youth", and you will only need to submit youth information.What type of registration is this?*Registering the first youthRegistering additional youthHow many youth are you registering in total?*OneTwoThreeFourYouth InformationYouth Name* First Last Gender*FemaleMaleDate of Birth* DD MM YYYY Age as of July 27, 2020*Please enter a number from 10 to 14.Allergies or medical conditions?Program InfoBreakout SessionClick to select - click again to deselect and choose another option Drawing Improv Painting Photography Stop Motion Animation DrawingDrawing - Spots available Spot 1 Spot 2 Spot 3 Spot 4 Spot 5 Spot 6 Drawing Waiting List ImprovImprov - Spots available Spot 1 Spot 2 Spot 3 Spot 4 Spot 5 Spot 6 Improv Waiting List PaintingPainting - Spots available Spot 1 Spot 2 Spot 3 Spot 4 Spot 5 Spot 6 Painting Waiting List PhotographyPhotography - Spots available Spot 1 Spot 2 Spot 3 Spot 4 Spot 5 Spot 6 Photography Waiting List Stop Motion AnimationStop Motion Animation - Spots available Spot 1 Spot 2 Spot 3 Spot 4 Spot 5 Spot 6 Stop Motion Animation Waiting List Registration InfoParent/Guardian Name (as indicated in the first youth's registration)* First Last Parent/Guardian Email (as indicated in the first youth's registration)* Guardian & Home InfoParent/Guardian #1 - Name* First Last Parent/Guardian #1 - Email* Parent/Guardian #1 - Cell Phone*Parent/Guardian #2 - Name First Last Parent/Guardian #2 - Email Parent/Guardian #2 - Cell PhoneHome Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone (if not a cell phone)ConsentsPARTICIPATION/MEDICAL: I give permission for the youth in my care noted above, to attend and participate in this program set forth by Northumberland Youth Unlimited (YFC) and/or Northumberland Promise. These programs include and are not limited to: in person events and online programs. I also give permission for the person(s) in charge to seek medical assistance for the youth in my care noted above in the event of accident or injury.* Yes, I give permission. No PERSONAL HARM: Furthermore, I agree to not hold Northumberland Youth Unlimited (YFC) and/or Northumberland Promise or any of its subsidiary programs, staff, volunteers, directors or officers responsible for any harm that may occur to the youth in my care noted above as a result of his/her wilful participation in the event.** Yes, I agree. No PHOTO/VIDEO: I do authorize Northumberland Youth Unlimited (YFC) and/or Northumberland Promise to take, use and own, in perpetuity; names, photographs or video/audio recordings of the youth in my care noted above, understanding that these may be used for public promotional purpose. Northumberland Youth Unlimited and Northumberland Promise do not sell or give away any recorded materials or personal information.** Yes, I authorize. No PaymentTotal spots reservedFees for spots selected* Price: $ 30.00 CAD $30 eachTotal $ 0.00 CAD Payment Method*Credit Card (via PayPal)E-TransferThank you for paying via e-transfer! After you click Submit below, you will receive an email with payment instructions.Thank you for paying via Credit Card! Once you click Submit below, you will be redirected to PayPal to complete your registration payment. You do not need a PayPal account (see image below).SIGNATURE: I acknowledge that clicking on the SUBMIT button below serves as my legal signature.*Yes, I acknowledge.NoCommentsThis field is for validation purposes and should be left unchanged.