Student Application Form
Student's Full Name
Enter your full legal name
Your answer
Student's Nick/Preferred Name
Your answer
Student Email Address
Your answer
Student Cell Phone
Required if student has a cell phone.
Your answer
Home Phone Number
Optional - if you have a land line at home
Your answer
Student Shirt Size
What size team shirt do you want? (only 1 shirt is provided to you)
School
School student is currently attending
Birth Date
Student's date of birth
MM
/
DD
/
YYYY
Grade
What grade is the student in for the 2017-2018 school year
Your answer
Have you previously been a member of Team Voltage?
Parent or other Legal Guardian Contact Information
Contact information one parent or one legal guardian. Information for an additional parent/guardian can be included in the following section.
Parent/Guardian Name
Full name of Parent or legal guardian
Your answer
Relationship
If not mother or father, please type in relationship
Parent/Guardian Address
Full mailing address
Your answer
Parent/Guardian Primary Phone Number
Your answer
What type of phone number ?
Email Address
Your answer
Emergency Contact?
Should this person be contacted in an emergency?
Additional Phone numbers
Optional: List additional phone numbers to be used case of emergency
Your answer
Parent or other Legal Guardian Contact Information
Additional parent or legal guardian information
Parent/Guardian Name
Full name of parent or legal guardian
Your answer
Relationship
If not mother or father, please type in the relationship
Parent/Guardian Address
Full mailing address
Your answer
Parent/Guardian Primary Phone Number
Your answer
What type of phone number ?
Additional Phone numbers
Optional: List additional phone numbers to be used case of emergency
Your answer
Emergency Contact?
Should this person be contacted in an emergency?
Additional Emergency Contact
If you must list an emergency contact other than the mother, father and/or legal guardians above, please indicate name, address and phone number below
Your answer
Medical
Medications
Choose None or List medications next to Other
Allergies
Choose None or List Allergies next to Other
Additional Information
If there is additional information that Mr. Gabeler should be aware of, please indicate below
Your answer
Describe Yourself!
Describe Yourself in 50 Words or less including at least one strength and one weakness
Your answer
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