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PCC Dirt Squad: Request for Youth Registration (2024)
Complete this form to be
eligible to register
for our youth programs.
This does not guarantee you a registration. Only registrations received after 7:00 pm on Wednesday April 3, 2024 will be considered.
We will send registration codes to valid requests in order of receipt until the program is full.
Priority will be given to recent youth member participants that complete the Google Form within 24 hours of the registration opening.
Youth programs usually fill up in just a few minutes, be quick!
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to save your progress.
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* Indicates required question
Email
*
Your email
Phone Number
*
Your answer
Parent Name
*
Your answer
Child 1 Name
*
Your answer
Child 1 Age (as of December 31, 2023)
*
Your answer
Is `Child 1` interested in being assessed for the Dirt Squad Team (Competitive Focus)?
*
Yes
No
Child 2 Name
Your answer
Child 2 Age (as of December 31, 2023)
Your answer
Is `Child 2` interested in being assessed for the Dirt Squad Team (Competitive Focus)?
Yes
No
Clear selection
Child 3 Name
Your answer
Child 3 Age (as of December 31, 2023)
Your answer
Is `Child 3` interested in being assessed for the Dirt Squad Team (Competitive Focus)?
Yes
No
Clear selection
Child 4 Name
Your answer
Child 4 Age (as of December 31, 2023)
Your answer
Is `Child 4` interested in being assessed for the Dirt Squad Team (Competitive Focus)?
Yes
No
Clear selection
A copy of your responses will be emailed to the address you provided.
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