Youth Crew Application

Name *

First Name

Last Name

Gender *

Check all that apply

Male

Female

Other

Prefer not to say

Race/Ethncity *

Check all that apply

African-American

Hispanic

Latino/Latina

White/Caucasian

Asian

Pacific Islander

Native American

Prefer not to say

Parent/Guardian 1 Phone Number *

(###)

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Parent/Guardian 2 Phone Number *

(###)

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