FutureforKIDS Discover Your Future Program Form

Discover Your Future Program

Future for kids serves students in 3-6th grade. Future for kids accepts students on a first-come, first serve basis. You will be notified via text message when your child has been accepted into the program or has been added to the waitlist. If waitlisted, you will be notified once your child has been moved from the waitlist to the active list. Form must be signed by legal guardian.
Student Information
How many students will you register today?*
Student #1 Information
Student Name #1*

First NameMiddle NameLast Name
Birth Date #1*

MonthDayYear
Date
Age #1*
Gender #1*

FemaleMale
Does this child have any allergies/ health related issues? If yes, please list below. Student #1 *
If not, please type in no.
Future for KIDS serves students in grades 3–6. Second graders are ONLY accepted IF they have an older sibling enrolled.
Grade #1*
Student #2 Information
Student Name #2*

First NameMiddle NameLast Name
Birth Date #2*

MonthDayYear
Date
Age #2*
Gender #2*

FemaleMale
Does this child have any allergies/ health related issues? If yes, please list below. Student #2*
If not, please type in no.
2. Future for KIDS serves students in grades 3–6. Second graders are ONLY accepted IF they have an older sibling enrolled.
Grade #2*
Student #3 Information
Student Name #3*

First NameMiddle NameLast Name
Birth Date #3*

MonthDayYear
Date
Age #3*
Gender #3*

FemaleMale
Does this child have any allergies/ health related issues? If yes, please list below. Student #3*
If not, please type in no.
3. Future for KIDS serves students in grades 3–6. Second graders are ONLY accepted IF they have an older sibling enrolled.
Grade #3*
Student #4 Information
Student Name #4*

First NameMiddle NameLast Name
Birth Date #4*

MonthDayYear
Date
Age #4*
Gender #4*

FemaleMale
Does this child have any allergies/ health related issues? If yes, please list below. Student #4*
If not, please type in no.
4. Future for KIDS serves students in grades 3–6. Second graders are ONLY accepted IF they have an older sibling enrolled.
Grade #4*
School*
Sunridge Information

6244 W Roosevelt St, Phoenix, AZ 85043 ~ Thursdays ~ 1:15pm-3:15pm ~ Registration open to all youth grades 3-6
Sun Canyon Information

8150 W. Durango St., Phoenix, AZ, 85043 ~ Wednesdays ~ 3:00pm-5:00pm ~ Registration open to all youth grades 3 - 6.
Western Valley Information

6250 W. Durango St. Phoenix, AZ 85043 ~ Mondays ~ 3:15pm - 5:15pm ~ Registration open to all youth grades 3 - 6.
CASA Academy Information

8047 N 35th Ave Phoenix, AZ 85051 ~ Wednesdays ~ 3:45pm - 5:45pm ~ Registration open to all youth grades 3 - 6.
Loma Linda Information

2002 E Clarendon Ave Phoenix, AZ 85016 ~ Mondays ~ 2:45pm - 4:30pm ~ Registration open to all youth grades 3 - 6.
Gateway Information

1100 N 35th St. Phoenix, AZ 85008 ~ Wednesdays ~ 1:30pm - 3:30pm ~ Registration open to all youth grades 3 - 6.
Conchos Information

1718 W Vineyard Rd Phoenix, AZ 85041 ~ Mondays ~ 3:00pm - 5:00pm ~ Registration open to all youth grades 3 - 6.
Percy L. Julian Information

2149 E. Carver Dr. Phoenix, AZ 85040 ~ Thursdays ~ 3:30pm - 5:30pm ~ Registration open to all youth grades 3 - 6.
Sousa Information

616 N. Mountain Rd. Mesa, AZ 85207 ~ Mondays ~ 2:00pm - 4:00pm ~ Registration open to all youth grades 3 - 6.
Taft Information

9800 E. Quarterline Rd. Mesa, AZ 85207 ~ Tuesdays ~ 2:45pm - 4:45pm ~ Registration open to all youth grades 3 - 6.
Whitman Information

1829 North Grand Mesa, AZ 85201 ~ Tuesdays ~ 2:00pm - 4:00pm ~ Registration open to all youth grades 3 - 6.
Thew Information

2130 E Howe Ave, Tempe, AZ 85281~ Tuesdays ~ 2:50pm - 4:50pm ~ Registration open to all youth grades 3 - 6.
Holdeman Information

1326 W 18th St, Tempe, AZ 85281, AZ 85282 ~ Wednesday ~ 3:00pm - 5:00pm ~ Registration open to all youth grades 3 - 6.
Roosevelt Information

828 S Valencia, Mesa, AZ 85202 ~ Thursdays ~ 2:00pm - 4:00pm ~ Registration open to all youth grades 3 - 6.
Spracale Information

1325 E Malibu Dr Tempe, AZ 85282 ~ Thursdays ~ 2:50pm - 4:50pm ~ Registration open to all youth grades 3 - 6.
Wood Information

727 W Cornell Dr Tempe, AZ 85283 ~ Tuesdays ~ 2:50pm - 4:50pm ~ Registration open to all youth grades 3 - 6.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Parent/Guardian Name *

First NameLast Name
Parent/Guardian's E-mail*
example@example.com
Parent/Guardian Phone Number*
*Questions listed below are optional helps Future for KIDS secure grants for program funding*
Number of people in Household.*
You may enter '0' if you prefer not to respond.
Household Income*

Less than $20,000$20,000 - $34,999$35,000 - $54,999$55,000+Prefer not to answer
Parent Education*

HighschoolCollegeGraduatePhDPrefer not to answer
Ethnicity*

African AmericaAsianHispanicNative AmericanPacific IslanderWhiteOtherN/A
Participant(s) lives with:*
AS PARENT OR LEGAL GUARDIAN, I ASSUME ALL RISKS & HAZARDS INCIDENTAL TO THE CONDUCT OF THE PROGRAM ACTIVITIES & TRANSPORTATION TO & FROM THE ACTIVITIES. I further hereby release, absolve, indemnify, and agree to hold harmless Future for KIDS, the organizers, sponsors, media and other third-party partners, and coaches, as well as the facility and administration of each of them, from any claim, demand, or action arising out of, or in any way related to the program including, but not limited to an injury to my child. In the event of an injury, the staff is authorized to obtain any medical care or treatment deemed necessary. By checking this box, you agree to receive text message reminders from Future for KIDS.*

Yes, I agree.
I hereby grant permission for photographs and/or videos to be taken of my child. I agree that Future for KIDS and third-party partners may use such photographs, videos, or other digital media of my child with or without their name and for any purpose. Including for example publicity, illustration, advertising, promotion, marketing, web content, any and all publications, newsletters, and brochures without payment or other consideration. I also agree to receive text messages from Future for Kids regarding program updates.*

Yes, I agree.No, I do NOT agree.
Signature

Clear
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Discover Your Future Program

Student Information

Student #1 Information

Student #2 Information

Student #3 Information

Student #4 Information

Sunridge Information

Sun Canyon Information

Western Valley Information

CASA Academy Information

Loma Linda Information

Gateway Information

Conchos Information

Percy L. Julian Information

Sousa Information

Taft Information

Whitman Information

Thew Information

Holdeman Information

Roosevelt Information

Spracale Information

Wood Information

Parent/Guardian Information

*Questions listed below are optional helps Future for KIDS secure grants for program funding*

Questions listed below are optional helps Future for KIDS secure grants for program funding