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Sisters In Christ Inc. Rose Application
It is with great pleasure that we invite you to apply to our SIC Inc. Rose program for girls ages 11-12. Application window is from March 25th
-April 12th. Please visit our website at
www.sistersinchristinc.org
for more information.
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* Indicates required question
Participant First Name:
*
Your answer
Participant Last Name:
*
Your answer
Participant Phone#:
Your answer
Participant Email Address:
Your answer
Gender:
*
Choose
Female
Male
Other
Date of Birth
*
MM
/
DD
/
YYYY
Age:
*
7 years old
8 years old
Other:
Home Address:
*
Your answer
Second Home Address (if different from above)
Your answer
What interest you most about the Daisies Program and what would you like to achieve from participating in the Program?
Your answer
Shirt Size:
*
Choose
YS
YM
YL
YXL
YXXL
XS
S
M
L
XL
XXL
Parent/Guardian Last Name:
*
Your answer
Parent/Guardian First Name:
*
Your answer
Parent/Guardian Phone #:
*
Your answer
Parent/Guardian email address:
*
Your answer
Emergency Contact Name:
*
Your answer
Emergency Contact Relation to Participant
*
Choose
Mother
Father
Grandparent
Auntie
Uncle
Emergency Contact Phone#:
*
Your answer
Emergency Contact Address:
*
Your answer
Does your child require an Epi-Pen?
*
Yes
No
Does your child have any allergies, of any kind?
If yes, please explain under "Other."
*
Yes
No
Other:
Required
Does your child require any medical aids or assistance?
If yes, please explain under "Other."
*
Yes
No
Other:
By checking yes, I grant Sisters In Christ Inc. permission to use images, recordings, and other likenesses of my child for SIC Inc. purposes.
*
Yes
Means of Transportation:
*
Car
Bus
Walking
Other:
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