Online Participant Application

Student's Information
* Name (First, Last, Middle):
* Address:
* City:
* State:
* Zip:
* Home Phone:
* Date of Birth:	(as mm/dd/yyyy)
* School:
* Grade:
* Shoe Size:
* T-Shirt Size:
* Student's Statement of Interest:	Please tell us 1) why you would like to participate in the program 2) what you hope to achieve by participating and 3) which sports activities you hope to be involved in.

* Student's Electronic Signature:	(provide your full name)
* Signature Date:	(as mm/dd/yyyy)
Parent(s)/Legal Guardian Information
* Parent(s) Names:
Address:	(only if different from above)
City:
State:
Zip:
* Home Phone:
* Work Phone:
* Email:
* Surveys:	As parents or guardian, would you like to participate in measurement surveys? Yes No
Permission
By electronically signing this application, I/We give permission for my child to participate in the Girls in the Game program sponsored by Sports Dreams, Inc. We also give permission for our/my child to be filmed and photographed during the course of the Girls in the Game program for the purpose of developing measurements and marketing materials for funds solicitation.

* Parent 1 Electronic Signaure:	(provide your full name)
Parent 2 Electronic Signaure:	(provide your full name)
* Signature Date:	(as mm/dd/yyyy)
* Required