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Youth Transformation Application and Evaluation
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* Indicates required question
PARENT #1 FIRST NAME
*
Your answer
PARENT #1 LAST NAME
*
Your answer
PARENT #1 EMAIL
*
Your answer
PARENT #1 PHONE
*
Your answer
PARENT #2 FIRST NAME
Your answer
PARENT #2 LAST NAME
Your answer
PARENT #2 EMAIL
Your answer
PARENT #2 PHONE
Your answer
YOUTH CLIENT FIRST NAME
*
Your answer
YOUTH CLIENT LAST NAME
*
Your answer
YOUTH CLIENT EMAIL
Your answer
YOUTH CLIENT PHONE
Your answer
YOUTH CLIENT DATE OF BIRTH
*
Your answer
YOUTH CLIENT AGE
*
Your answer
YOUTH CLIENT BLOOD TYPE
*
A
B
AB
O
YOUTH CLIENT GENDER
*
MALE
FEMALE
YOUTH CLIENT HEIGHT
*
Your answer
YOUTH CLIENT WEIGHT
*
Your answer
WHAT IS THE MAIN GOAL FOR THE YOUTH CLIENT?
*
DISCIPLINE
KNOWLEDGE
SUPPORT
GUIDANCE
LOSE FAT
BUILD MUSCLE
OTHER
IF OTHER, PLEASE ELABORATE
Your answer
DOES THE YOUTH PARTICIPATE IN SPORTS?
*
YES
NO
IF YES, WHICH SPORTS DO THEY PARTICIPATE IN?
Your answer
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