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Student Name
*
Returning Student
Yes
No
Student's Grade
*
Kindergarten
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Student's current grade
Student School
Enter student's school name
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Parent/Guardian Email Address
*
Parent/Guardian Phone Number (2)
Parent/Guardian Name (2)
Parent/Guardian Email Address (2)
Parent Availability to Coach (list days/times)
e.g. Monday through Friday evenings or Saturday 8-5, Sunday 12-5
Epipen
Select Yes or No
Yes
No
Does the student require an epipen?
Emergency Contact Name
*
Emergency Contact Phone
*
Relation to Student
*
Accommodations Needed
Please list any requested accommodations. BCFR will make every effort to ensure all students are able to participate in a team.
Student's T-shirt Size
Please select a size
YS (Youth Small)
YM (Youth Medium)
YL (Youth Large)
AS (Adult Small)
AM (Adult Medium)
AL (Adult Large)
AXL (Adult XL)
AXXL (Adult XXL)
Student Gender
Please choose a gender
Male
Female
Non-binary
Prefer not to disclose
Student Gender
Allergies
Does the student have any known allergies?
Student Ethnicity
Select an ethnicity
Asian
Black/African American
American Indian or Alaska Native
Hispanic./Latino
Native Hawaiian or Pacific Islander
White
Prefer not to disclose
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