Astronomy Tours S.COOP

Youth Division Registration Form

Thank you for your interest in joining División Juvenil, the Astronomy Tours Youth Training and Participation Program.

Participant Information

Full name

Date of birth

Month

Day

Year

Age

Nationality

Address

City

Postal code

Email address (if applicable)

Mobile phone (if applicable)

Parent / Legal Guardian Information

Guardian full name

Relationship to participant

Guardian email address

Guardian mobile phone

Alternative emergency contact number

Education

Current school

Current school year

Languages spoken

Areas of Interest

Previous Experience

Previous experience

Availability

Additional availability information

Medical Information

Allergies

Medical conditions

Medication requirements

Additional safety information

Emergency Contact

Emergency contact name

Emergency contact relationship

Emergency contact phone number

Confirmations

I confirm the information provided is accurate.

I understand that participation is voluntary and educational in nature.

I understand that participation does not create an employment relationship.

I confirm that this application is being submitted by or with the knowledge and consent of the participant’s parent/legal guardian.

I agree to follow all safety instructions issued by Astronomy Tours S.COOP.

Applican't signature

Parent / guardian signature

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Date