Youth Financial Literacy Academy Registration Form

Program (check one)

Real World Money (Level 1)

Legacy Money (Level 2)

Program Location (check one)

Buladean Community Center

AMY Wellness YMCA

Student Full Name

This field is required.

Age

This field is required.

Allergies?

Yes

No

This field is required.

If yes, Please specify.

Medical Conditions?

Yes

No

This field is required.

If yes, please specify.

Special Accommodations?

Yes

No

This field is required.

If yes, please specify.

Emergency Medical Authorization

Yes

No

This field is required.

Photo Permission(Check all that apply)

Program Social Media

Helping Hands Website

Flyers & Promotional Materials

Grant Reporting

I do NOT give permission for photos/videos.

Participant Expectations

Be respectful to staff and fellow students.

Follow all program rules.

Arrive on time and participate.

Take care of program materials and classroom space.

Parent/Guardian Full Name

This field is required.

Email

This field is required.

Date

This field is required.

How did you hear about this program?

AMY Wellness YMCA

Buladean Community Center

Social Media

Other

If Other, please specify

Youth Financial Literacy Academy Registration Form

Youth Financial Literacy Academy Parent/Guardian Registration Form

student information

Health Information

Parent information