Board Bootcamp, Youth Edition — Registration
Submit your Youth Leader’s registration request and guardian permissions for the three-day program.
Youth Leader Information
Youth Leader Legal Name
*
First Name
Middle Name
Last Name
Youth Leader Preferred Name
*
Youth Leader Grade
*
6
7
8
Youth Leader School
*
Youth Leader Age
*
Parent/Guardian and Emergency Contact Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Program Selection and Support Needs
Food Allergies and Dietary Needs
*
No known allergies or dietary needs
Vegetarian
Vegan
Gluten-free
Dairy-free
Nut allergy
Other
Accessibility or Accommodation Requests
Authorized Pickup Names
*
Additional Comments
Scholarship Intent and Guardian Acknowledgments
Scholarship intent note
Guardian acknowledgment: permission to participate
*
I acknowledge and give permission for the participant to attend and take part in the program.
Guardian acknowledgment: emergency contact authorization and registration follow-up
*
I authorize the program to contact me about registration and to use the emergency contact information provided if needed.
Photo and media consent
I grant permission for photos or media of the participant to be used for program-related purposes.
I do not grant photo or media permission.
Submit Registration Request
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