APPLY FOR PRAISE HIM COLLECTIVE

Thank you for your interest in joining Praise Him Collective.

Please complete this form below in its entirety.

Praise Him Collective Application

Please fill out this form completely.

The "applicant" is considered the individual interested in participating in Praise Him Collective (ages 4-18).

The "parent/gaurdian" is the parent/gaurdian of the individual applying ("applicant").

Applicant (child ages 4-18)'s Information

Applicant's First Name

Applicant's Last Name

Applicant's Email Address (leave blank if you would like us to contact parent/gaurdian).

Applicant's Phone Number (leave blank if you would like us to contact parent/gaurdian).

Address

Applicant's Date of Birth

Month

Day

Year

Are you suffering from a medical condition, illness or injury?

Yes

If you answered yes to any of the questions above, please supply additional information.

Parent/Gaurdian's Information:

Parent/Gaurdian's Full Name

Parent/Gaurdian's Phone Number

Parent/Gaurdian's Email Address

Emergency Contact #1 Information:

Emergency Contact #1's Full Name

Emergency Contact #1's Phone Number

Emergency Contact #1's Email Address

Emergency Contact #2 Information:

Emergency Contact #2's Full Name

Emergency Contact #2's Phone Number

Emergency Contact #2's Email Address

Initials of Person Completing This Form

I declare that the info I’ve provided is accurate and complete.

I understand that this form is an application and Praise Him Inc. will be contacting the applicant and/or parent/guardian indicated above for more details.

APPLY FOR PRAISE HIM COLLECTIVE

Thank you for your interest in joining Praise Him Collective. Please complete this form below in its entirety.

Praise Him Collective Application

Thank you for your interest in joining Praise Him Collective.

Please complete this form below in its entirety.