MBA Mentors Program Application

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Please complete the form and click submit at the bottom

Applicant name or names *

Parent name (if applicant is under 18)

Email Address *

Phone number *

This program has 3 components. Please indicate what components you want to apply for. The components marked optional may be added later if you are unsure now. *

1. Mentoring: (required) Mentors will meet with students in small groups and sometimes individually. This will be addition to the boxing/kickboxing program.

2. Competition: (optional) for students interested in joining the competition team and eventually competing. Schedules and requirements will be different at times.

3. Personal Trainer Pathway: (Optional) students will learn how to create training programs, facilitate training sessions and work towards certification.

Required

What level of support do you need from MBA and community sponsors? *

Level 1: No financial help needed. Child can participate in all parts of the program and the family can pay for all required expenses.

Level 2: Partial support. Training fees will be reduced. We will discuss cost of any needed equipment or registration fees for events and work with families to cover a percentage of expenses.

Level 3: full support. Family cannot afford costs of training or equipment. We will work with community sponsors to provide everything that is needed.

Required

This section is for the applicant. Please tell us a little bit about yourself and why you would like to join this program. *

Please review our waiver and accept the terms below

Please check the box below to indicate that you accept the terms of the waiver and you are knowingly applying to participate in the activity program *

I accept

Required

Signature - Type name below to sign and complete application *

Parent signature if applicant is under 18 years old

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