Program Participant Application

2018 Participants Contract and Parental Consent Form.

Legal name of participant (must match BIRTH CERTIFICATE). For additional questions please contact us at 618-274-5437.

Click here for a PRINTABLE APPLICATION FORM

Emergency Contact Information:

Additional Information

Important Disclosures

Click here to print the 2018 Parental/Guardian Permission and Waiver document and Student Records and Shared Agreement Contract

BRING IN PRINTED AND SIGNED WAIVERS TO THE JACKIE JOYNER KERSEE CENTER TO COMPLETE REGISTRATION. IF YOU CAN NOT PRINT THE ABOVE WAIVER COME INTO THE CENTER TO COMPLETE REGISTRATION FOR DESIRED PROGRAM(S).