Sons Of Someone Mentoring Program 2026

Sons Of Someone Mentoring Program 2026

Males ages 12-18
Youth Information
Youth Name

First NameLast Name
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Youth Email Address
example@example.com
Youth Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Ethnicity

Other
Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Relationship to Youth

Other
If other, please specify
Emergency Contact Name

First NameLast Name
Emergency Contact Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Health Information
Medical Conditions
Medical Insurance Provider
Policy Number
Parent/Guardian Application Questions
Please describe your child’s strengths, interests, and personality.
What are your goals for your child’s participation in the Sons of Someone Mentoring Program?
Describe any challenges, concerns, or support needs you would like the mentor or program to be aware of.
Has your child participated in any mentoring, counseling, tutoring, or similar support programs before? If yes, please describe.
Is there anything else you would like us to know about your child or family as we consider this application?
I assume full responsibility for any risks, loss, or personal injury that may be sustained by me/my child, or any loss or damage to property owned by me/my child, during the time he is participating in, or traveling to or from Sons of Someone. I release and agree to indemnify and hold harmless Sons of Someone and, its staff, employees and agents from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my child’s involvement in Someone’s son, and to reimburse them for any such expenses incurred. By checking box below, I acknowledge that I have read, understand and agree to the terms outlined above:
I hereby give permission for my child to be photographed, I understand the photos will be used to keep a journal of activities, and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that his/her identity will not be disclosed, I do not expect compensation. Please check box below.
Should be Empty:

Sons Of Someone Mentoring Program 2026

Youth Information

Parent/Guardian Information

Health Information

Parent/Guardian Application Questions