999 GREEN BAY ROAD, GLENCOE IL 60022 (847) 835-3030 FAX: (847) 835-7279-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Family Last Name and Parents’ First Names in the designated fields.
3. Fill in your Address, City/State, Unit # (if applicable), and Zip Code accurately.
4. Provide your Home Phone # and a required Cell Phone # for contact purposes.
5. Enter your Email address, which is necessary for Park District communication.
6. Complete the Emergency Contact section with a name and phone number.
7. List the Activity #, Participant’s First Name, Activity Name, Birth Date, Current Grade, and Gender for each participant.
8. Indicate if you would like to make a donation by checking the appropriate box.
9. Fill out Payment Information including Cardholder’s Name, Card Number, Expiration Date, and V-Code. Select your payment method.
10. Sign the waiver section to confirm you have read and agree to its terms before submitting the form.

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