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APPLICATION
(
ple
ase submit a separate a
pplication for each child)
Parent/Guardian's Information
Parent/Guardian's name
Home Address
Number of adults living in household
Phone number
Relationship to child applicant(s)
Number of children living in household
Email address
Are you applying for more than one child?
Does the family receive any public assistance benefits?
Is there anything else you would like us to know about your family or household?
Child's Information
Child's name
Does the child identify as Black, Indigenous, or a Person of Color (BIPOC)?
Child's date of birth
Does the child identify with any other historically marginalized group?
Child's current school and grade level
Does the child have health insurance?
What activity does your child want to pursue? Remember it doesn't have to be something you see already on the website. We are always happy to search out new instructors in new activities!
Is there anything else you would like us to know about your child?
SUBMIT!
Thank you for submitting!
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