Young Debs Inc Sponsorship Application 2023-2024

Debs and Gents Membership Registration Application 2023-2024

SPONSORSHIP REQUEST FORM

***This form is to be completed by a parent/gaurdian of student who is requesting a partial or full sponsorship to help cover the cost of yealry dues.
Which Program are you applying for (please check ONLY one)*

DebsGents
Student Information
Student's Name*

First NameLast Name
Birth Day (MM/DD/Year)*
School's Name*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Hobbies and Interest (click all that apply)*

ReadingDancePhotographySingingActing/TheatreSportPlaying an instumentDrawing/PaintingOther
How did you hear about us? (Please click all that apply):*

A friend/colleagueAt SchoolAttending an eventSocial Media (FB, IG, Twitter)Other
Parent/Guardian Information
Name*

PrefixFirst NameMiddle InitialLast NameSuffix
Address (if different from student address)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (home)
Phone Number (mobile)*
Email
example@example.com
Preferred Contact for Updates and Reminders (Please circle):
Preferred Contact for updates and reminders*

Cell phone textEmailPostal MailOther
EMERGENCY CONTACT INFORMATION

Each student must have two emergency contacts.
Emergency Contact #1 Name*

PrefixFirst NameMiddle InitialLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (mobile)*
Phone Number (work)
Please enter a valid phone number.
Phone Number (home)
Please enter a valid phone number.
Emergency Contact #2 Name*

PrefixFirst NameMiddle InitialLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (mobile)*
Phone Number (work)
Please enter a valid phone number.
Phone Number (home)
Please enter a valid phone number.
Membership Rules Signing this application is an indication that I, the parent/guardian and I, the student, have agreed to fully participate in the program I have applied for. This includes attending and/or actively participating in community service projects, social events, fundraising events, etiquette.

The parent and student, agree to follow the rules and regulations established by Young Debs Inc. I also agree to uphold those standards while participating in the program. I also understand that if I fail to abide by those standards, I may forfeit my participation in the program and all privileges provided by Young Debs

I, the parent, also agree to uphold the rules and regulations established by Young Debs Inc and assist in ensuring my daughter/son abides by those standards. I understand that the organization has the right to add addendums to the handbook as needed and will be notified if such changes occur.

I also confirm that all information provided in the application is true, and that falsifying any information may cause my child(ren)'s dismissal from the program. I, the parent, agree to submit all dues by the deadline.I understand the program dues are $450 for the year regardless if my child participates in all events. However, I am requesting a sponsohip to help reduce the cost so my child may actively participate. If a partial sponsorhsip is granted I agree to pay the remianing balance. If my child does not actively participate, I understand that the sponsorship maye be forfieted.
Signature*

Clear
Date*

MonthDayYear
Date
As a parent or guardian of this student, I hereby consent to the use of photographs/videotape taken during the course of the school year for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources I do this with full knowledge and consent and waive all claims for compensation for use, or for damages. I have read, understood and accepted the photo release form.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Student Information

Parent/Guardian Information

EMERGENCY CONTACT INFORMATION