• Operation Dream New Registration

  • Parent/Guardian Information

  • Please select one:*
  •  -
  • Martial Status*
  • You can contact me through the following methods: (Check all that apply)*
  • Guardian Type:*

  • Would you be interested in more information about volunteering with Operation DREAM?
  • How did you hear about Operation DREAM?*

  • Please list all children in household
    Rows
  • Languages spoken*

  • Are you or any member in your household on active military duty?*
  • Are you or any member of your household a previous participant in Operation DREAM program?*
  • If yes, please list their names

  • Member Information

  • Birthday*
     - -
    2 digit month, 2 digit day, 4 digit year
  • School Lunch Program Eligibility*
  •  -
  • Ethnic Origin*

  • T-shirt Size*
  • Member Lives with (check all that apply)*

  • Does child spend time with any male role models?*
  • Today's Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Member Health History & Emergency Care Plan

  •  -
  • Special Medical Conditions
  • Does your child have Asthma?*
  • Do they have an inhaler?*
  • Does the child have any allergies or dietary religious restrictions?*
  • If yes, please check all that apply

  • Is there other information we need to know about allergies?*
  • Does your child use an epi-pen?*
  • Please list all medications that will be brought to the Saturday program or field trips.
  • Does your child use any other prescriptions or over the counter medications not listed above?*
  • Today's Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Transportation

  • My child needs transportation to programming*
  • My child will arrive by way of: (check all that apply)*

  • My child is authorized to leave by way of: (check all that apply)*

  • My child is authorized to be picked up by the following person(s) - Name & Phone Number*

  • Emergency Contacts

  •  -
  •  -
  •  -
  •  -

  • In consideration of {childsName} (minor) permitted by Operation DREAM to participate in its activities and to use its equipment and facilities. I further agree to indemnify and hold harmless from any and all Claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

  • Work Experience

  • Has your child indicated an interest in a career?*
  • Does your child have job experience?*
  • Type a question
    Rows
  • Should be Empty: