Please complete this form and submit it BEFORE your child starts your Passport to Winter Fun.
Why does this matter? Your input helps us understand the real impact of our program. Since we don't have another way to track participation and reach, we rely on information collected at the start and end of the program to see where our outreach is working well—and where we can do better. By taking the time to register your child and share results with us at the end, you're helping us serve families even more effectively. Thank you!
How do we use your information? We use this data solely to evaluate program effectiveness and improve our outreach efforts. Your information is kept confidential and is never shared with third parties or used for any purpose other than program assessment.

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* 1. Flap #

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* 2. Full Name:

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* 3. Age:

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* 4. Gender:

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* 5. School:

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* 6. In the last 7 days, how many days were you physically active for at least one hour?

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* 7. Did you do any of the activities with your family?

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* 8. Parent's or Guardian's Email (optional)

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* 9. Would you like to receive Winter Fun Weekly? We share important updates and announce Grand Prize winners every week from January through April. (optional)

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