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LOGAN Recreation Activities
Winter, 2013
Online Registration

Participant Information

Date

First Name

Last Name

Address
City			Zip

Email Address

Confirm Email

Home Phone

Cell

Birthdate

Age

Grade

Gender

M F

Parent, Legal Guardian, or Agency Information

First Name

Last Name

Relationship to Participant

Address
City			Zip

Email Address

Confirm Email

Home Phone

Cell

Work Phone

Activity Enrollment

After School Adventure Camp

LEGO Club (ages 6-12) $42

Passport to Your Palate (ages 8-12) $45

Passport to Your Palate (ages 13-18) $36

Swim Lessons I (ages 3-5) $48

Swim Lessons II (ages 6-12) $48

Swim Lessons III Saturdays (ages 13-18) $54

Gals Get Together (ages 13-21) $64

Creative Expressions (ages 7-12 )$22

Creative Expressions (ages 13-18) $22

Agility & Sports Skills Session I (Jan16-Feb20) $54

Agility & Sports Skills Session II Mar6-Apr17) $54

Ceramics (ages 7-12) $35

Ceramics (ages 13-18) $35

Sugar Cube Art (ages 7-12) $16

Sugar Cube Art (ages 13-18) $16

Swim and Pizza Night (ages 5-18) $8 per child check dates:	Jan 11	Feb 22
	Mar 22	Apr 29

Strikes and Spares (ages 10-18) $17 per date	Jan 26	Feb 16
	Mar 23	Apr 20

Twilight Egg-citing Activities (ages 4-12) $8

Karate (ages 6-12) $88

Social Connections (pay per week)

Teen Time (pay per week)

Hang Time (ages 14-18) $10 per date Please check dates you would like to attend:
Jan 4	Jan 18	Feb 1
Feb 15	March 8	April 12
April 26

A Golden Night Prom $5

LOGAN Community Resources, Inc.
2505 E. Jefferson Blvd. • South Bend, IN 46615
(574) 289-4831
logan@logancenter.org
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