THE STEWART FOUNDATION YOUTH MEMBERSHIP APPLICATION/FORM

YOUTH MEMBERSHIP APPLICATION/FORM

For youth ages 8–18 who have not graduated from high school Thank you for your interest in The Stewart Foundation (TSF). This is a one-time membership application. Please complete all required fields. The youth applicant and parent/legal guardian must review the Acknowledgement & Agreement and sign at the end.
YOUTH APPLICANT INFORMATION

One form per child
Youth's Full Name

First NameMiddle NameLast Name
Gender
Date of Birth

MonthDayYear
Date
Age
Current Age
Cell Phone Number
Area code & seven digit numberFormat: (000) 000-0000.
Email Address
example@example.com
Address

Street Address

County

CityState

Zip Code
SCHOOL INFORMATION
Name of School
Elementary, Middle, or High School
Location
County
Current Grade
Anticipated Year of Graduation
Enter 4-digit year: Ex. 2026
PARENT/LEGAL GUARDIAN INFORMATION
Parent/Legal Guardian Name

PrefixFirst NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship
TERMS AND CONDITIONS OF PARTICIPATION
Attestation:

I affirm that the information provided in this application is accurate to the best of my knowledge. I agree to follow TSF rules, be punctual and kind, and meet program requirements, including participation in a minimum of six (6) Stewart Foundation-sponsored workshops, events, or activities during each fiscal year.

Acknowledgement and Agreement:

By by signing below, the Youth Applicant and Parent/Legal Guardian acknowledge that they have reviewed this application and the following TSF participation requirements and agree to comply with them:

• Participation and conduct: Follow TSF rules, expectations, schedules, and instructions and conduct oneself respectfully.

• Participation requirement: The youth member agrees to participate in at least six (6) TSF-sponsored workshops, events, or activities each fiscal year.

• Photography/Video Release: Parent/Legal Guardian grants TSF permission to use the youth participant’s likeness in photographs, video, or other digital media for TSF publications, web-based publications, and communications/publicity, without compensation.

• Release of Liability/Assumption of Risk: The Parent/Legal Guardian and participant acknowledge and assume the risks associated with TSF events and activities and release, indemnify, and hold harmless TSF and the releasees identified in the original Terms and Conditions, to the fullest extent permitted by law.

• Driving/Carpooling: Parent/Legal Guardian acknowledges the TSF Driving and Carpooling Policy and agrees that the youth participant will comply with that policy. Violations may affect continued participation.
SIGNATURES

By signing below, I confirm that I have reviewed the completed application, understand the Acknowledgement & Agreement, and agree to the terms and conditions applicable to participation in The Stewart Foundation youth program.
Youth Signature
Date Youth Signed

YearMonthDay
Date
Parent/Guardian Signature
Date Parent/Guardian Signed

YearMonthDay
Date
Should be Empty:

YOUTH MEMBERSHIP APPLICATION/FORM

YOUTH APPLICANT INFORMATION

SCHOOL INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

TERMS AND CONDITIONS OF PARTICIPATION

SIGNATURES