I'm a... (which best describes you) Pick One Youth Parent Guardian Teacher Church Leader Neighbor Citizen Other (list in Notes section)
Name of Youth
Youth's Date of Birth
Your Name
Remain Anonymous (check box and we won't mention you)
Location of Youth State Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
The following questions should be answered about the Youth...
1. Extra curricular activity needing to be paid for Pick One 4H Airsoft Archery Ballet Baseball Basketball Baton Twirling Battle Reenactments Beachcombing Bellringing Birdwatching Body Boarding Bowling Bodybuilding Boy Scouts Camping Canoeing Canyoning Caving and potholing Cheerleading Chess Clay Pigeon Shooting Climbing Coasteering Cricket Croquet Cross County Curling Dancing Debate Diving Dog Sledding Dragon Boat Racing Driving Fishing Footbags Football Free Running and Parkour Frisbee Golf Gardening Geocaching Girl Scouts Go Karting Golf Grow your own vegetables Gymnastics Horse Riding Ice Climbing Ice Hockey Ice Racing Ice Skating Jogging and Running Kayaking Kite Surfing Lacrosse Land Boarding Land Yachting Laser Tag Live Action Role Playing Games Monster Truck Racing Motor Cross Motor Racing Mountain Biking Mountain Boarding Mountaineering Netball Off Road Motor Sports, Rallying and 4x4 Orienteering Paintballing Polo Racketball Remote Control Cars Road Cycling Rock Climbing Rodeo Roller Hockey Roller Skating/Blading Rowing Rugby Safari Sailing Science Club Scuba Diving Skateboarding Skid Pan Driving Skiing Skipping Sledding Sledging Snorkeling Snow Kiting Snowboarding Snowmobiling Softball squash Stock Car Racing Surfing Swimming Tall Ship Crewing Tennis Track and Field Trail Running Trekking Ultimate Frisbee Volleyball Wakeboarding Walking Water Polo Water Skiing Whale Watching Whitewater Rafting Wild Swimming Windsurfing Wrestling Yachting Zorbing/Sphering Other (list in Notes section)
2. Willingness to provide community service in exchange for sponsorship Pick One Very Willing Willing Somewhat Willing Not Willing Other (list in Notes section)
3. Financial hardship affecting the household Pick One Loss of Income Loss of Parent/Guardian Health Problems Non-Traditional Family Unsupportive Parent/Guardian Other (list in Notes section)
4. Best character trait Pick One Ambitious Compassionate Confident Courageous Determined Enthusiastic Friendly Honest Intelligent Loving Pleasant Responsible Self-reliant Studious Trustworthy Unselfish Other (list in Notes section)
5. Other info (share any additional information that may help us) Insert notes here...