Summer

2020 Summer Activity Guide

Morton Grove Park District Activity Guide

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register at mortongroveparks.com | 2020 Summer Activity Guide HOUSEHOLD ENROLLMENT FORM YOU MUST CREATE A HOUSEHOLD ENROLLMENT ACCOUNT PRIOR TO REGISTERING ONLINE. Help us help you in creating your NEW Household Account. COMPLETE this form and submit it to Prairie View Community Center. PLEASE NOTE: TWO FORMS OF IDENTIFICATION WILL BE NEEDED TO SHOW PROOF OF RESIDENCY. Prairie View Community Center, 6834 Dempster St, Morton Grove, IL 60053 Phone: (847) 965-1200 Fax: (847) 965-4115 mortongroveparks.com PRIMARY GUARDIAN FIRST AND LAST NAME _______________________________________________________________________________________ ADDRESS ______________________________________________________ CITY _________________________ ZIP ________________ PRIMARY PHONE ______________________________________ OTHER PHONE _______________________________________________ EMAIL ADDRESS __________________________________________________________________________________________ BIRTH DATE __________ SECONDARY GUARDIAN FIRST AND LAST NAME ____________________________________________________________________________________ ADDRESS ______________________________________________________ CITY _________________________ ZIP ________________ PRIMARY PHONE ________________________________________ OTHER PHONE _____________________________________________ EMAIL ADDRESS __________________________________________________________________________________________ BIRTH DATE __________ ADDITIONAL FAMILY MEMBERS (FIRST AND LAST NAME) SCHOOL BIRTH DATE GENDER M F M F M F M F M F M F M F RESIDENCY VERIFIED □ STAFF INITIALS __________ Household Enrollment Form 65

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