Corning Youth Center
SUMMER 2021
Registration Form
To best serve the community, the Laura Richardson Houghton Corning Youth Center will remain open from 8AM -6 PM for youth 8-18. We will take a limited number of youth and you will be contacted by program, this is in effort to continue with social distancing and safety guidelines, while supporting youth educational needs. In order for your child(ren) to be considered, you will need to complete the attached form, and each child will need their own form completed. At this time we cannot be a drop in center and for that we are truly sorry but we are hoping to support your youth in other ways during these times.
Are you interested in youth or teen programming for your child? *
Online or Blended Summer School? *
Preferred Method of Contact: *
Do you receive any public assistance? *
Can you provide a face mask for your child? *
Is your child at high-risk for contracting COVID-19? *
Do you consent for your child to have their temperature tested before entering the Youth Center? *
Has your child been vaccinated for COVID-19? *
 
Can you provide sunscreen? *
Is your child allergic to anything? *
Parent/Guardian signature (By signing below I attest that my child will not be sent to the Youth Center if sick, I understand that my child will be isolated if becoming ill after arrival. I understand that I may be ask to provide medical documentation to allow my child back into the program if sick). *
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