Registration

School *

Chester Deep River Essex Homeschooled

I give my child permission to walk home *

yes no

I give Tri-Town permission to use screen shots of my child for promotional purposes *

Yes No

Participant information (Providing the following information is optional; however, it affords the State of CT a clearer picture of who is served by Youth Service Bureaus throughout the state. Student names are not included in any data that is reported to the State of CT):

Child’s identified race

Select OneCaucasian African-American/Black Hispanic/Latinx Asian American Indian/Alaska Native Native Hawaiian/Pacific Islander Multiracial prefer not to answer

Who this child lives with:

Select One2 birth or adoptive parents 1 step & 1 birth parent 1 single mom 1 single dad grandparent(s) DCF foster parent(s) lives alone parents have joint custody other

Is this child experiencing homelessness?

Select Oneno yes lives in a shelter lives in someone else’s house lives in a hotel or motel lives on own and homeless other prefer not to answer

Registration Fees