Never The Less Student Enrollment Form
Never The Less Program Enrollment Form
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Email *
PROGRAMS & EVENTS  YOU WANT TO PARTICIPATE IN:  *
STUDENT INFORMATION
Student's First Name *
Student's Last Name *
Student's Age *
Student Birthdate
MM
/
DD
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YYYY
Student's Grade *
Student's Street Address *
Student's City, State and Zip code *
Student's Email (if applicable)
Student's Cell Phone (if applicable) - providing the student's cell phone provides consent for us to call or text the student if necessary regarding class issues only.
Student's T-shirt Size *
Does your child have reliable transportation to and from the Never The Less program (7162 Reading Rd. in Roselawn)? *
How will your child travel to and from the program? *
If there is an issue with your child's regular transportation, please provide an alternate name (and phone number) of someone else who can pick up your child. *
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