Student Participation Form
Beyond Your Block will host a day at the track, with Founder Rodney "Red" Grant and local male students from the DC and PG area.

Date: Tuesday June 28th
Departure Time: 9:45 AM in Navy Yard DC
Return Time: 2:30 PM Navy Yard DC

Lunch will be provided, parents and guardians must be on time to pick their students up and/or waive them arriving and departing via public transportation.

Eligibility to participate:
* Must be 12 - 17 years old
* This group is specifically for young men who are interested in mentorship
* Students must have transportation to and from the designated pick up/drop off location  

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Email *
STUDENT NAME *
Age *
School *
City *
Required
Parent/Guardian Name *
Parent/Guardian Number *
By completing this form I hereby give Hustlers Guild and its employees, representatives, and authorized media organizations permission to print, photograph, and record my child for use in audio, video, film, or any other electronic, digital and printed media. *
A copy of your responses will be emailed to the address you provided.
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