BIGG BOI STATUS PROGRAM APPLICATION FORM

BIGG BOI STATUS PROGRAM APPLICATION

Please fill out all information as accurate as possible.
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Academic Information
Highest Education
Date Last Attended

MonthDayYear
Date
What Milestones or Achievements you've got while you're on school?

Parental Consent and Release Form

For Applicants 18 Years old below
As a parent or legal guardian, I affirm that I have been completely informed of all the program and activities that the child/youth will participate. I understand the general structure of the activities/programs and do not need to be informed of each and every activity.

I hereby voluntarily release, forever discharge the community, the corporation, its officers, directors, employees, volunteer and agents from any and all claims, demands, or causes of action, which are connected with my child's participation in the programs or the use of technique and methods.

I confirm that I have fully informed myself of the contents of this Parental Consent and Release Form by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.
Parent/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Signed

MonthDayYear
Date
Signature

I AFFIRM THAT ALL STATEMENTS I HAVE INDICATED HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY MISREPRESENTATION I HAVE MADE CAN CAUSE FOR THE INVALIDATION OF MY APPLICATION AND SHALL BAR ME FROM RE-APPLYING FOR THE SAME.
Applicant's Signature
Name of Applicant

First NameLast Name
Date Signed by Applicant

MonthDayYear
Date
Should be Empty:

BIGG BOI STATUS PROGRAM APPLICATION