Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Child's InformationFirst Name *Last Name *Date Of Birth *YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920MM123456789101112DD12345678910111213141516171819202122232425262728293031Gender *MaleFemaleGrade Level *--- Select Choice ---3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th Grade Emergency Last Emergency Allergies, Restrictions or Special NeedsPlease note and allergies, restrictions or special needs.Guardian InformationGuardian Name *Guardian Mobile Phone *SMS Consent (For RSVPs / Reminders)I agree to receive automated texts from FLAR about Thrive/Driven/Rise program reminders and updates (up to 4/month). Msg & data rates may apply. Reply STOP to opt out or HELP for help. Consent isn’t required to participate. We never sell or share your number.Why we ask for SMS: We use text messages to send monthly event RSVPs and reminders—typically about 3 days before each gathering—so you don’t miss anything and we can plan an accurate headcount.Guardian Email *Emergency Contact 1Primary emergency contact for the participant.Emergency Contact 1 Name *Emergency Contact 1 Relationship *--- Select Choice ---ParentFoster ParentGuardianSocial WorkerOtherEmergency Contact 1 Phone *Emergency Contact 2Secondary emergency contact for the participant (optional).Emergency Contact 2 NameEmergency Contact 2 Relationship--- Select Choice ---ParentFoster ParentGuardianSocial WorkerOtherEmptyEmergency Contact 2 PhoneSubmit
