Ballers Conference Registration

Baller’s Conference Registration Form 2022

Parent First Name *

Parent Last Name *

Home Phone Number *

Mobile Phone Number *

Email Address *

Student(s)

Student First Name *

Student Last Name *

Student Email

Student Mobile Phone Number

Grade *

T-Shirt Size *

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Parent Consent

I am the parent or legal guardian of the child/youth/children named above, and grant consent for their attendance at ICE Mentors programs. I also grant ICE Mentors my permission to us the child/youth/children likeness in photographs for any legal use, including but not limited to: publicity, copyright purposes, advertising, and web content.

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Ballers Conference Registration

Student(s)

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