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JR. GUARD APPLICATION
Junior Guard Supervisor: Chief Aaron Tartal and Chief Cody Quig

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 $100 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