fallregistration2024to2025sponsorship

[et_pb_section fb_built=”1″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_row _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”]

Fall Registration 2024 to 2025 Sponsorship

 

[/et_pb_text][et_pb_text _builder_version=”4.24.2″ _module_preset=”default” hover_enabled=”0″ sticky_enabled=”0″]

First Name *

Last Name *

Grade *

Age *

Gender *

School *

Parent First Name *

Parent Last Name *

Email Address *

Phone *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe

Ethnicity *Hispanic, LatinoAsianWhiteBlack or African AmericanHawaiian or other Pacific IslanderAmerican Indian or Alsaka NativeMulti RaceOther

Household Income *Less than 15K15 - 25 K25 - 45KLess than 100K

First Name *

Last Name *

Emergency Contact # *

Allergies or Special Notes about your child

Photography *You can use my childs photo in social media postsYou may not use my childs photo

To participate in New Life Youth. I hereby state that I am voluntarily allowing my child/children to participate in this program, and I recognize that certain risks and dangers inherent in the participation in this type of activity. I understand New Life Youth cannot and does not guarantee or ensure the safety of my child. I am willing to assume any risk of personal injury or property damage to my child/children in order to allow him/her to participate in this program. In consideration of New Life Youth allowing my child/children to participate in this program, I hereby agree to release, hold harmless, and defend the city of Vancouver, New Life Youth and their officials, administrations, employees, coaches, volunteers, and agents from any and all claims for damages and/or injury to my child. I, the parent/guardian, will be responsible for picking up my child from this event. I further understand that I may be contacted if such an event was to occur.

Submit

[/et_pb_text][et_pb_contact_form email=”youth@onlygod.world” _builder_version=”4.24.2″ _module_preset=”default” _unique_id=”319d46f1-c0b3-4f78-b2aa-31ed600c9076″ hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″ disabled_on=”on|on|on” disabled=”on”][et_pb_contact_field field_id=”First_Name” field_title=”First Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Last_Name” field_title=”Last Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Grade” field_title=”Grade” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Age” field_title=”Age” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”School” field_title=”School” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Gender” field_title=”Gender” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Parent_First_Name” field_title=”Parent First Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Parent_Last_Name” field_title=”Parent Last Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Phone” field_title=”Phone” allowed_symbols=”numbers” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Email Address” field_type=”email” _builder_version=”4.16″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Address_Line_1″ field_title=”Address Line 1″ fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”Address_Line_2″ field_title=”Address Line 2″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”City” field_title=”City” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”State” field_title=”State” field_type=”select” select_options=”%91{%22value%22:%22Alabama%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Alaska%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Arizona%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Arkansas%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22California%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Colorado%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Connecticut%22,%22checked%22:0,%22dragID%22:5},{%22value%22:%22District of Columbia%22,%22checked%22:0,%22dragID%22:6},{%22value%22:%22Delaware%22,%22checked%22:0,%22dragID%22:7},{%22value%22:%22Florida%22,%22checked%22:0,%22dragID%22:8},{%22value%22:%22Georgia%22,%22checked%22:0,%22dragID%22:9},{%22value%22:%22Hawaii%22,%22checked%22:0,%22dragID%22:10},{%22value%22:%22Idaho%22,%22checked%22:0,%22dragID%22:11},{%22value%22:%22Illinois%22,%22checked%22:0,%22dragID%22:12},{%22value%22:%22Indiana%22,%22checked%22:0,%22dragID%22:13},{%22value%22:%22Iowa%22,%22checked%22:0,%22dragID%22:14},{%22value%22:%22Kansas%22,%22checked%22:0,%22dragID%22:15},{%22value%22:%22Kentucky%22,%22checked%22:0,%22dragID%22:16},{%22value%22:%22Louisiana%22,%22checked%22:0,%22dragID%22:17},{%22value%22:%22Maine%22,%22checked%22:0,%22dragID%22:18},{%22value%22:%22Maryland%22,%22checked%22:0,%22dragID%22:19},{%22value%22:%22Massachusetts%22,%22checked%22:0,%22dragID%22:20},{%22value%22:%22Michigan%22,%22checked%22:0,%22dragID%22:21},{%22value%22:%22Minnesota%22,%22checked%22:0,%22dragID%22:22},{%22value%22:%22Mississippi%22,%22checked%22:0,%22dragID%22:23},{%22value%22:%22Missouri%22,%22checked%22:0,%22dragID%22:24},{%22value%22:%22Montana%22,%22checked%22:0,%22dragID%22:25},{%22value%22:%22Nebraska%22,%22checked%22:0,%22dragID%22:26},{%22value%22:%22Nevada%22,%22checked%22:0,%22dragID%22:27},{%22value%22:%22New Hampshire%22,%22checked%22:0,%22dragID%22:28},{%22value%22:%22New Jersey%22,%22checked%22:0,%22dragID%22:29},{%22value%22:%22New Mexico%22,%22checked%22:0,%22dragID%22:30},{%22value%22:%22New York%22,%22checked%22:0,%22dragID%22:31},{%22value%22:%22North Carolina%22,%22checked%22:0,%22dragID%22:32},{%22value%22:%22North Dakota%22,%22checked%22:0,%22dragID%22:33},{%22value%22:%22Ohio%22,%22checked%22:0,%22dragID%22:34},{%22value%22:%22Oklahoma%22,%22checked%22:0,%22dragID%22:35},{%22value%22:%22Oregon%22,%22checked%22:0,%22dragID%22:36},{%22value%22:%22Pennsylvania%22,%22checked%22:0,%22dragID%22:37},{%22value%22:%22Rhode Island%22,%22checked%22:0,%22dragID%22:38},{%22value%22:%22South Carolina%22,%22checked%22:0,%22dragID%22:39},{%22value%22:%22South Dakota%22,%22checked%22:0,%22dragID%22:40},{%22value%22:%22Tennessee%22,%22checked%22:0,%22dragID%22:41},{%22value%22:%22Texas%22,%22checked%22:0,%22dragID%22:42},{%22value%22:%22Utah%22,%22checked%22:0,%22dragID%22:43},{%22value%22:%22Vermont%22,%22checked%22:0,%22dragID%22:44},{%22value%22:%22Virginia%22,%22checked%22:0,%22dragID%22:45},{%22value%22:%22Washington%22,%22checked%22:0,%22dragID%22:46},{%22value%22:%22West Virginia%22,%22checked%22:0,%22dragID%22:47},{%22value%22:%22Wisconsin%22,%22checked%22:0,%22dragID%22:48},{%22value%22:%22Wyoming%22,%22checked%22:0,%22dragID%22:49}%93″ _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Zip_Code” field_title=”Zip Code” fullwidth_field=”on” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Ethnicity” field_title=”Ethnicity” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22Hispanic, Latino%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Asian%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22White%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Black or African American%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Hawaiian or other Pacific Islander%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22American Indian or Alsaka Native%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Multi Race%22,%22checked%22:0,%22dragID%22:5},{%22value%22:%22Other%22,%22checked%22:0,%22dragID%22:6}%93″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”Household_Income” field_title=”Household Income” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22 Less than 15K%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22 15 – 25 K%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22 25 – 45K%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22Less than 100K%22,%22checked%22:0,%22dragID%22:2}%93″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”Emergency_First_Name” field_title=”Emergency First Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Emergency_Last_Name” field_title=”Emergency Last Name” _builder_version=”4.24.2″ global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][/et_pb_contact_field][et_pb_contact_field field_id=”Emergency_Contact_#” field_title=”Emergency Contact #” allowed_symbols=”numbers” fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”Allergies_or_Special_Notes_about_your_child” field_title=”Allergies or Special Notes about your child” field_type=”text” required_mark=”off” fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][et_pb_contact_field field_id=”Photography” field_title=”Photography ” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22 You can use my childs photo in social media posts%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22You may not use my childs photo%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][/et_pb_contact_field][/et_pb_contact_form][et_pb_text _builder_version=”4.24.2″ _module_preset=”default” hover_enabled=”0″ global_colors_info=”{}” disabled_on=”on|on|on” disabled=”on” sticky_enabled=”0″]

To participate in New Life Youth. I hereby state that I am voluntarily allowing my child/children to participate in this program, and I recognize that certain risks and dangers inherent in the participation in this type of activity. I understand New Life Youth cannot and does not guarantee or ensure the safety of my child. I am willing to assume any risk of personal injury or property damage to my child/children in order to allow him/her to participate in this program. In consideration of New Life Youth allowing my child/children to participate in this program, I hereby agree to release, hold harmless, and defend the city of Vancouver, New Life Youth and their officials, administrations, employees, coaches, volunteers, and agents from any and all claims for damages and/or injury to my child. I, the parent/guardian, will be responsible for picking up my child from this event. I further understand that I may be contacted if such an event was to occur.

[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]