Homerun Registration Form

HOMERUN Registration

ONE FORM REQUIRED PER CALENAR YEAR
First Name*
Last Name*
Birth Date*
Ethnic Ogrin*
Kids Ages 0-8*
Kids Ages 9-17*
Address*
City*
State*
E-mail*
Phone Number*
I am the head of my household.*

Agree
I give consent to be contacted via the following: Phone Call/Text/Email*

Agree
I give consent for SWING! Foundation Inc. to provide my contact information to resource providers within their network, if my needs are outside their capabilities.*

Agree
I understand that SWING! Homeruns are provided for (3) consecutive months per calendar year, and to re-apply for the following year, I will be asked to complete the on-line financial literacy course available via the SWING! Foundation, Inc. website.*

Agree
We grant permission to SWING! Foundation, Inc. hereinafter known as the ‘Media’ to use our images (photographs and/or video) for use in Media publications including: Videos, Email Blasts, Event Planning, Newsletter, Magazines, Social Media, General Publications, Website and/or Affiliates. We hereby waive any rights to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known or unknown, and We waive any rights to royalties or other compensation arising from or related to the use of the image in conjunction with them now or in the future, whether that use is known or unknown to us. * We refers to the applicant listed above and minors in her care.*

Agree
PLEASE SELECT YOUR (3) HOMERUN PICK-UP LOCATIONS / DATES FROM THE OPTIONS PROVIDED BELOW.

PICK-UP TIMES ARE FROM 2PM - 4PM.
Homerun #1*
Homerun #2*
Homerun #3*
Signature*

Powered by Jotform SignClear
Should be Empty:

HOMERUN Registration