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JR. GUARD APPLICATION
Junior Guard Supervisor: Lt. Emily Pendleton

Name                                                                                                               
(please print)      Last                              First                              MI                
Date of Birth:___________________        Age:________
Summer                                                                                                           
Address                         Number                                  Street                       
                                                                                                                        
                                       City                       State                    Zip               
                                                                                                                    
Summer Telephone  (          )                      
Winter                                                                                                              
Address                         Number                                    Street                           
                                                                                                                        
                                       City                       State                    Zip                     
                                                                                                                          
Winter Telephone  (          )                                                                               
Email                                        @                                                                   
                                                                                                                 
Parents/Guardians Name_______________________________________________
Work Telephone  (          )                                                                                  
T-Shirt Size
  Small Medium Large X- Large

Youth

       

Adult

       
Short Size
  Small Medium Large X- Large

Youth

       

Adult

       

Parents/Guardians Signature___________________________________________
Just follow these steps to ensure proper delivery:
1. Print Application
2. Fill Out
3. Make check payable to: Rehoboth Beach Patrol Donation Fund
4. Mail to:
           (June - Sept.)
           Rehoboth Beach Patrol Headquarters
           Attn. Junior Guards
           1 Baltimore Ave.
           Rehoboth Beach, DE 19971

           (Oct. - May)
           City of Rehoboth Beach
          
Attn. Junior Guards
           229 Rehoboth Avenue

           Rehoboth Beach, DE 19971

Fees: For one child is $95 and for every child after that is an additional $55
For More information feel free to call the Rehoboth Beach Patrol Headquarters at
(June - Sept.) call 302-227-2280 (Oct.- May) call
227-6181(Attn: Junior Lifeguards)                                Back