Registration plus a uniform is $40.
Step 1 – Fill out the form.
Step 2 – Pay at the bottom of the page.
Name of Mentee:
Age of Mentee:
Mentee Cell Number:
Mentee School Name:
Mentee Graduation Date:
Father's / Guardian Name:
Father's Cell Number:
Mother's / Guardian Name:
Mother's Cell Number:
Emergency Contact Name:
Emergency Contact Phone:
Does your child have any food allergies? :
Student's Sports (Check all that apply):
BasketballBaseballFootballTrack & FieldSoccerLacross
Please tell us about your child strengths and weaknesses:
Does your child have any medical or physical challenges that require assistance?:
Goals you would like to see achieved through this mentoring program:
Briefly tell us why you have chosen to this mentoring program for your child:
If your child needs a uniform, what is the unifom size?
Make sure to complete STEP 1 above so that we have the information. Next, complete step 2 below.
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