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First Name (Parent)     Last Name Email Address City State    Zip                  Phone    Youth Name (1) Age Youth Name (2) Age Youth Name (3) Age Youth Name (4) Age Schedule Tuesday • Wednesday • Thursday at 4pm TARGEYouth Program Fall Session 1 (6 weeks each) : Fall I Tuesdays (September 4th to October 9th) Fall I Wednesdays (September 5th to October 10th) Fall I Thursdays (September 6th to October 11th) May attend all three sessions per week   TARGEYouth Program Fall Session 2 (6 weeks each) : Fall II Tuesdays (October 16th to November 20th) Fall II Wednesdays (October 16th to November 21st) Fall II Thursdays (October 16th to November 22nd) May attend all three sessions per week Would be interested in attending at other times: Monday 4 PM Saturdays before 10 AM Saturday late morning Saturday afternoon Sunday before 10 AM Sunday late morning Weekdays 5 PM Other please indicate: Am 13 years or older:                             Not yet 13 years old 13 Years or Older   or