Her Game Fest: Beyond the Ball - Dallas Wings Game Experience
Thursday, August 20 - Depart TBD
Student Name
*
First Name
Last Name
Student Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student Phone Number
Student's Home Address, City and Zip Code
*
Address and zip code are required for participation.
Student's School
*
Student's Grade
*
Student's Race (Check all that apply)
*
Black/African American
Hispanic/Latino
Native American/American Indian
Asian/Pacific Islander
White/Caucasian
Other
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
*
2nd Parent/Guardian Phone (if applicable)
Download and read the
DHNS Youth Program Participation Waiver.
Signature - Please sign below.
*
Submit
Should be Empty: