2022 Registration

Name*
First Last
Date Of Birth*
MM slash DD slash YYYY
Age*
Email*
Phone Number*
Please do not use hyphens in your entry.
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Shoe Size*
T-Shirt Size*
How Did you hear about Us ?*
Has your child been picked on, bullied, or teased in past or present ?*
Does your child struggle with low self confidence ? *If yes, please explain.
- Yes
- No
*Optional
Does your child struggle with self identity issues? *If yes, please explain.*
- Yes
- No
*Optional
Would you say your child is an Introvert or Extrovert ?*
- Introvert
- Extrovert
What Motivates your child ?*
Lists your child's hobbies*
Does your child have any special talents or interests ?
Does your child go to public school, home school or private school?*
- public school
- home school
- private school
Photo ( Head Shot and Full Body)*
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