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Reserva de juego abierto
First Name
Last Name
Email
Phone
Full Address
Additional information for Your Application(s)
Gender
Choose an option
What City & State are you located in?
Why do you want to be an explorer?
What type of Pioneering do you need?
Choose an option
Please list some hobbies or areas of interest (5)
Ethnicity
Are you willing to teach a skill of your choice from the Follow My Steps Curriculum to a explorers?
Would you like to showcase your skills?
Choose an option
How many hours a week can you meet with your pioneer?
Choose an option
Do you have access to a computer with video capability?
Choose an option
What do you want to achieve in life?
What days are you able to meet with your Pioneer?
*
Obligatorio
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Do you identify with any disabilities?
Do you understand there is a monthly fee ($55) associated with being in our program?
Choose an option
Do you understand that our program runs adjacent the school year and you will be expected to attend Follow My Step program activities during that time? Failure of proper notification or missed activities may result in dismissal from the program. *
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Read Waiver
I am over 18 or the legal guardian of the participant above and I accept the terms of the waiver.
Your Signature
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Birthday
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Thank you!
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