ElevateHER Network, Inc. Participant Application (Ages 6

ElevateHER Network, Inc. Participant Application (Ages 6–18)

Thank you for applying to ElevateHER Network! We are excited to review your application and welcome you into a sisterhood where girls rise with confidence, clarity, and purpose. You will receive next steps via email within 5–7 business days.
SECTION 1: Participant Information

Tell us about the participant.
Participant Full Name

First NameLast Name
Preferred Name
Date of Birth

MonthDayYear
Date
Age
Current Grade Level
School Name
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
SECTION 2: Parent/Guardian Information

Parent or guardian details for contact and consent.
Parent/Guardian Full Name
Relationship to Participant
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent Email Address
example@example.com
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
SECTION 3: About You

Help us get to know the participant.
Three words that describe you
Things you enjoy doing
Something you are proud of
What would you like to grow in this year?
Why do you want to join ElevateHER?
SECTION 4: Goals & Leadership

Share your dreams and experiences.
What are your dreams for the future?
What does leadership mean to you?
SECTION 5: Academic Support

Let us know how we can support your learning.
Areas where you would like support

Other
Does participant have an IEP or 504 Plan?
If yes, please explain:
SECTION 6: Health & Safety

Health information for participant safety.
Does participant have allergies?
Does participant have medical conditions we should know about?
Please explain any medical needs:
SECTION 7: Commitment Agreement

Read and agree to the ElevateHER Sisterhood Commitment.
SECTION 8: Parent Consent

Parent/guardian permission is required for participation.
SECTION 9: Media Release

Photo & Media Release Consent.
Photo & Media Release
SECTION 10: T-Shirt Size

Select participant's t-shirt size.
T-Shirt Size
SECTION 11: Signature

Sign below to complete your application.
Participant Signature
Parent/Guardian Signature
Upload File (optional, e.g., report card)

Cancelof
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ElevateHER Network, Inc. Participant Application (Ages 6–18)

SECTION 1: Participant Information

SECTION 2: Parent/Guardian Information

SECTION 3: About You

SECTION 4: Goals & Leadership

SECTION 5: Academic Support

SECTION 6: Health & Safety

SECTION 7: Commitment Agreement

SECTION 8: Parent Consent

SECTION 9: Media Release

SECTION 10: T-Shirt Size

SECTION 11: Signature