Please provide the following contact information:

                 (we'd like to say Happy Birthday to you in our newsletter!)

Parent's Name:

Parent's Email:

Parent's Phone:

Emergency Contact 

 (someone other than your parents)

Emergency contact's phone: 

Any additional information we should know:

Note:  Parents are welcome to attend all Coyote events. Teens must check in at each activity. Teens and their guests are expected to honor Coyote policies; and the authority of the Coyote Advisor.  Though there will be adults attending the activities, teens will be responsible for their own actions. Parents who agree to allow their teen to attend Coyote events imply that their teen is responsible enough to act in a mature manner, and can be trusted. Teens and their parents will be responsible to make restitution for any damages caused during any Coyote event. In the event of accident or injury, by allowing your teen to attend Coyote events, parents agree to hold harmless Nevada Christian Home School and their representatives, including the operator of any vehicle (if necessary) providing transportation to any event. Activity time schedule will be honored, parents are responsible to pick up their teen on the scheduled time.  Parents understand there is no guarantee that teen advisors will remain after the designated activity time.  Coyote Advisors do not supervise the coming and going of Teens, particularly those who drive themselves to any Coyote activity.  We support parental authority and we encourage parents to decide whether a Coyote event is suitable for their teen.