LeadUS Mentoring Program 2015-16

Welcome to the BH Youth Mountain Bike Club! We are so excited to be able to offer a few scholarships this year! Please fill out this form and we will get back to you ASAP if your child is chosend for the scholarship. Scholarships are chosen on a case-by-case basis and we will fullfil as many as possible. Your information is strictly confidential, used for this purpose only and WILL NOT be shared with anyone.

Child Information:
School name*
Grade as of Fall 2020
Child's Height
Does Your Child Have a Bike to Use?
If yes, is it a mountain bike?
Does this child play other sports/ enjoy other activities? Activity 1
Activity 2
Activity 3
Other Hobbies/ Interests
Pleas share with us why you think your child would benefit from the BH Youth Mountain Bike Club*

0/300
Can this child ride a bike?
Race of child:

Financial Information
Those that are requesting it will be evaluated in their economical aspects in order to be qualified for scholarships.
Youth parents are:

EmployedUnemployedUnder employedSingle Parent HomeOther
Mother's Name
Age
Profession
Monthly Salary
Father's Name
Age
Profession
Monthly Salary
How many people live in your house including child?
Is there any other information that you would like to share with us?
Do you agree to submit only accurate and true information?*

Yes, I agree / Understand
Should be Empty: