You R You Alternate Payment Options Registration Form 2025

Parent Contact Information:

First Name:

Last Name:

Email:

Phone:

Relationship to Child:

Are you their Emergency Contact?

Do you want to add a second contact?

Yes

First Name:

Last Name:

Email:

Phone:

Relationship to Child:

Preferred Address:

Address

Apt, Suite or Bldg.

City/Town

State/Province

ZIP/Postal Code

Participant Information

First Name:

Last Name:

Gender:

Preferred Pronouns:

Date of Birth:

Name of School, Fall 2025

Please list any known allergies – if none put NA

Please list any medications the participant is currently taking

Please select a t-shirt size (Adult Sizing)

Participant Waiver

Please click here to view the waiver.

signature

I agree to the Participant Waiver

By checking this box, I confirm I have read, understood, and agreed to these terms and conditions from United Way of Washington County-East and Hidden Pines Ranch.

Complete Registration

Scholarship and/or Payment Options

Full Scholarship

Partial Scholarship

Cash/Check

Other…

Please select a scholarship option, or if you are paying via cash/check make checks payable to United Way of Washington County-East either

Drop at our Office:
123 2nd St. Suite 201 Stillwater, MN 55082

Mail it To:
UWWCE
PO Box 305 Stillwater, MN 55082

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