Membership Form
Heroic Inner Kids Membership Form
Email address *
Legal First Name *
Your answer
Legal Last Name *
Your answer
Nickname
Your answer
Street Address *
Your answer
Zip Code *
Your answer
Facebook ID *
Your answer
Cell Phone *
Your answer
Typical Availability *
Required
Characters Typically Played
Hero
Villian
Other
DC
Marvel
Disney
Anime
Furry
Storybook
Star Wars
Whovian
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Outstanding Medical Issues (Seizures, Panic Attacks, anything that we would NEED to report in case of emergency only) *
Your answer
By submitting this application with my typed signature, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. *
Your answer
Application submission date: *
MM
/
DD
/
YYYY
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