6TH GRADE
“PRE-TEEN MONDAYS”
REGISTRATION

6TH GRADERS STORM THE DEPOT!!

Beginning Monday, September 9th, JUST the 6th graders are invited to spend every Monday afternoon from 3:00- 6:00 at The Depot!! Hot meals will be served and all activities will be supervised by Depot staff and volunteers.

When leaving, if your pre-teen is not walking home, they must be picked up at The Depot, located at 214 Main St. in East Jordan, by 6:00.

There is NO COST to attend, however, registration is required by submitting the Teen Registration form below. If you have any questions, please call Scott Gillespie, Depot Outreach Director, at (989) 444-1695.

Finally, you are highly encouraged to CLICK HERE to receive text notifications with updates on programming, upcoming events, cancellations, etc.

Click to Review Permissions and Agreements

Teen's Profile Information *

First

Last

Birth Month *

Birth Date *

Birth Year *

Age *

Grade *

Multiple Choice

Male
Female

Street Address *

City *

Zip Code *

Email *

Phone Number *

School District *

Parent/Guardian Info *

First

Last

Phone Number #1 *

Relationship #1 *

Parent #2 Name

First

Last

Phone Number #2

Relationship #2

Emergency Contact Info (Other than Parent) *

First

Last

Emergency Phone Number *

Emergency Relationship *

Family Physician

Preferred Hospital

Preferred Hospital Phone

Insurance Company

Insurance Company Policy Number

Insurance Company Phone Number

Health Conditions

By submitting this registration form, we - parent(s) and teen - acknowledge that we have read, understand, and agree to the Permissions and Agreements whose link is provided above. *

We have read, understand, and agree to the Permissions and Agreements

Teen's Profile Information *

First

Last

Birth Month *

Birth Date *

Birth Year *

Age *

Grade *

Multiple Choice

Male
Female

Street Address *

City *

Zip Code *

Email *

Phone Number *

School District *

Parent/Guardian Info *

First

Last

Phone Number #1 *

Relationship #1 *

Parent #2 Name

First

Last

Phone Number #2

Relationship #2

Emergency Contact Info (Other than Parent) *

First

Last

Emergency Phone Number *

Emergency Relationship *

Family Physician

Preferred Hospital

Preferred Hospital Phone

Insurance Company

Insurance Company Policy Number

Insurance Company Phone Number

Health Conditions

By submitting this registration form, we - parent(s) and teen - acknowledge that we have read, understand, and agree to the Permissions and Agreements whose link is provided above. *

We have read, understand, and agree to the Permissions and Agreements

Get In Touch

Address

"The Teen Zone"
214 Main St. | PO Box 283
East Jordan, MI 49727

Phone

office | (231) 222-2224
cell & text | (989) 444-1695

Email

DepotJVTeenCenter@gmail.com

Subscribe Here to receive text notifications of reminders and upcoming events

6TH GRADE“PRE-TEEN MONDAYS”REGISTRATION

6TH GRADERS STORM THE DEPOT!!

Get In Touch

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Phone

Email

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6TH GRADE
“PRE-TEEN MONDAYS”
REGISTRATION