2018.19 MEMBERSHIP FORM
City you live in *
Your answer
Members First Name *
Your answer
Members Last Name *
Your answer
Birth Date *
Your answer
Members Cell Phone Number
Your answer
Which location are you planning to attend? *
Education/Activity Information
Current Grade in School *
What town is your school in?
Your answer
School
Your answer
Have the members parents graduated from college?
School/Community Activities currently involved in
Your answer
Parent Information
Parent/Guardians Name(s) *
Your answer
Relation to Member *
Your answer
Parent/Guardians Cell Phone Number *
Your answer
Parent/Guardians Email Address *
Your answer
Alternative Emergency Contact
First & Last Name *
Your answer
Phone Number *
Your answer
Health Alerts
Please include any and all medication(s). Please be advised that if your daughter becomes ill while participating in a True Eagles activity you will be called first and then the alternative person. We will call the Emergency Number (911) for services as we deem needed. As such, We are NOT liable for any payment.
Health issues that should be noted *
Your answer
Please list all medicaton(s) below
Your answer
Guardian & Applicant Signatures Required to complete the application process. *
(from Participant & Parent/Guardian)
Required
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