Youth Programming Δ 1Parent/Guardian information2Student’s information32nd Student’s information4Subtotal and Payment button PhoneThis field is for validation purposes and should be left unchanged.First tell us about yourself:Parent/Guardian name(Required) First Last This field is hidden when viewing the formSection Break bypass infoAddress(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code email(Required) Primary Phone(Required)Emergency Phone if DifferentThis field is hidden when viewing the formSection BreakI'd like to register(Required) 1 student 2 students (if more than 2, please submit multiple forms) Now please tell us about the student you would like to register:Student's Name(Required) First Last Student's Birthdate (Enter or choose)(Required) MM slash DD slash YYYY AgeGrade in 25-26(Required)These workshops are geared to students aged 6 to 14. Unfortunately your child does not fall within this age range and you cannot register. If there are unusual circumstances you wish to discuss with us please email us at info@brighthillpress.org .These workshops are geared to students aged 6 to 14. Unfortunately your child does not fall within this age range and you cannot register. If there are unusual circumstances you wish to discuss with us please email us at info@brighthillpress.org .This field is hidden when viewing the formThis student: Attends school in Delaware or Otsego couny Attends school outside of the above area This student:(Required) Attends Delaware Academy Attends another school in Delaware or Otsego county Attends school outside of the above area School(Required)SchoolPlease tell us about allergies, medications or other things we need to know.Workshops are $250 each.A partial scholarship may be available because this student attends school in Delaware or Otego county. Workshops will be priced at $170 each pending verification.A full scholarship is available because this student attends Delaware Academy! You will not be charged for workshops although donations to help others attend always are welcome.I like to register this student for:(Required) Workshop #1 – Warm places! Whales, Aboriginal art and poetry. Feb. 16-20 Workshop #2 – Chimps/Jane Goodall and Gorillas/Dian Fossey Apr. 6-10 Workshop #3 – Sticks and stones Proverbs and building materials June 29-Jul 3 Workshop #4 – Creek Critters- Nature Observation July 20-24 #1 – Warm places! Whales, Aboriginal art and poetry. Feb. 16-20 Price: W1 lowW1 low#2 – Chimps/Jane Goodall and Gorillas/Dian Fossey Apr. 6-10 Price: W1 lowW1 low#3 – Sticks and Stones Proverbs and building materials June 29-July 3 Price: W1 lowW1 low#4 – Creek Critters – Nature Observation July 20-24 Price: W1 lowW1 low#5 – “What a glorious morning for America!” 1775 how we lived. Quill and parchment Aug. 10-14Sorry, this workshop is full.W1 lowW1 low Second Student's Name(Required) First Last 2nd Student's Birthdate (Enter or choose)(Required) MM slash DD slash YYYY 2nd Student's Age2nd Student's Grade in 25-26(Required)These workshops are geared to students aged 6 to 14. Unfortunately your child does not fall within this age range and you cannot register. If there are unusual circumstances you wish to discuss with us please email us at info@brighthillpress.org .These workshops are geared to students aged 6 to 14. Unfortunately your child does not fall within this age range and you cannot register. If there are unusual circumstances you wish to discuss with us please email us at info@brighthillpress.org .This student:(Required) Attends Delaware Academy Attends another school in Delaware or Otsego county Attends school outside of the above area This field is hidden when viewing the formThis student:(Required) Attends school in Delaware or Otsego couny Attends school outside of the above area 2nd Student's School(Required)2nd Student's SchoolPlease tell us about allergies, medications or other things we need to know about your 2nd student..Workshops for this student are $250 each.A partial scholarship may be available because this student attends school in Delaware or Otego county. Workshops will be priced at $170 each pending verification.A full scholarship is available because this student attends Delaware Academy! You will not be charged for workshops although donations to help others attend always are welcome.I like to register the 2nd student for:(Required) Workshop #1 – Warm places! Whales, Aboriginal art and poetry. Feb. 16-20 Workshop #2 – Chimps/Jane Goodall and Gorillas/Dian Fossey Apr. 6-10 Workshop #3 – Sticks and stones Proverbs and building materials June 29-Jul 3 Workshop #4 – Creek Critters- Nature Observation July 20-24 #1 – Warm places! Whales, Aboriginal art and poetry. Feb. 16-20 Price: W1 lowW1 low#2 – Chimps/Jane Goodall and Gorillas/Dian Fossey Apr. 6-10 Price: W1 lowW1 low#3 – Sticks and stones Proverbs and building materials June 29-July 3 Price: W1 lowW1 low#4 – Creek Critters – Nature Observation July 20-24 Price: W1 lowW1 low#5 – “What a glorious morning for America!” 1775 Aug. 10-14Sorry, this workshop is full.W1 lowW1 low Subtotal $0.00 This field is hidden when viewing the formsubScholarships are made possible by the Kellogg foundation and by supporters like you. Although you have no payment due because you’ve received a scholarship, if you can donate any amount to help students who cannot otherwise attend it would be much appreciated.Scholarships are made possible by the Kellogg foundation and by supporters like you. If you can donate any amount to help students who cannot otherwise attend it would be much appreciated.Extra donation for Youth Workshops Total I would like to pay: Now, online with a credit card I’d rather mail a check Please mail your check to:Bright Hill Press Youth Workshops94 Church St. Treadwell NY 13846When you proceed below you will be taken to Paypal to complete your transaction. Note you do not need a PayPal account — just click on “Pay with Debit or Credit card” at the Paypal screen.
