Boys to Men Conference 2019 - Level Up
Join us for Sow A Seed Community Foundation's annual Boys-to-Men Conference. This FREE conference will be held on Saturday, December 7th, 2019 at Kimball High School in Tracy, from 8:30 am - 2:30 pm( Doors open at 8 am). This conference is open to boys ages 10 -18. The Boys-to-Men Conference is an uplifting and positive event using real-life approaches for realistic results. In this conference participants attend professionally delivered workshops, hear a keynote address, and ask questions during a panel discussion. A catered lunch is also included. The key focus areas include healthy lifestyles, personal accountability, leadership development and alternatives to deviant behavior. Register Now!!
Email address *
Name of Attendee (First, Last) *
Your answer
Address *
Your answer
City, State and Zip Code *
Your answer
Attendee's Email address
Your answer
Date of Birth (make sure to type in correct year) *
MM
/
DD
/
YYYY
Grade *
If Grade is "OTHER", please explain
Your answer
School Currently Attending *
Your answer
Referred by: *
Parent/ Guardian Name (First, Last) *
Your answer
Relation to Attendee *
Number in Household
Housing status
Youth's Sexuality
Annual Household Income
Does Youth Qualify for Free or Reduced Lunch Program at school?
Source of Household Income (check all that apply)
Ethnicity (check all that apply) *
Required
Parent/ Guardian Acknowlegement *
Required
Parent/ Guardian Contact Phone Number xxx-xxx.xxxx *
Your answer
Other Phone Number
Your answer
Emergency Contact Name (2nd contact in the event that we cannot reach you) *
Your answer
Emergency Contact phone number xxx-xxx-xxxx *
Your answer
Are any special accommodations needed or dietary restrictions? *
If special accommodations needed or dietary restrictions, please explain.
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Sow A Seed Community Foundation. Report Abuse