Indio Teen Center

Thank you for applying to become a member. Once completing the form, please click the Submit button. The form will be converted into a pdf and you will be able to print and return to the Indio Teen Center for processing.

Print Document

When you click Print below we will prepare a printable document for you. It will automatically download when it's ready.

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You can fill in the document online and then click the print icon and all of your information will be populated in the printable document, saving you time later.

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Indio Teen Center Registration Form

Please fill out the form to the best of your ability. If your Parent/Guardian does not have access to email, plese use your email address or an accessible email address and have your Parent/Guardian sign from there. You will be prompted to add an email address after you (Participant) sign the form.

Please check that you agree before continuing.

By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.

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Signature will be applied to the page. You will have a chance to review after signing.

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Additional Signatures Required

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Please provide accurate information below to ensure the delivery of the signed copies of the document.

Listed Signers

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Participant
Parent/Guardian
I'm not a signer listed above