FAN Membership Application Name * First Last Date of Birth * Gender * Male Female Street Address * City * State * Zip Code * Phone Number * Email Address * Are you currently living in a foster home? * Yes No If yes, please provide the name of your foster parent(s)/guardian(s). How long have you been in foster care? * Are there any siblings in the foster care system as well? * Yes No What grade are you currently in? * How are your grades in school? * Do you participate in any extracurricular activities or sports at school? * Are you interested in participating in sports and athletic activities? * Have you played any sports before? * Yes No If yes, please specify. Do you have any specific athletic goals or aspirations? * In what ways do you think the Foster Athletic Network can support you? * Are there any specific challenges or barriers you are facing that you would like assistance with? * Do you have access to sports equipment and facilities? * What are your hobbies or interests outside of school? * Are there any specific activities or programs you would like to participate in? * Do you have any medical conditions or allergies that we should be aware of? * Are you currently receiving any medical or counseling services? * Name of parent(s)/guardian(s) (if applicable) Contact information of parent(s)/guardian(s) Relationship to the child Is there anything else you would like us to know about you or your situation?
