Pre-registration for Bridge Builders #YOUnified17 is open!

This year’s event will be Friday, Aug. 4, from 5-9 p.m. at Tiger Lane. Registration is mandatory.

Please note: This is a youth-only event, and gates will close promptly at 6 p.m.

 



Participant Birthdate (MM/DD/YYYY)


Participant Gender:

Participant Ethnicity:

Have you ever participated in a BRIDGES event? If so, please click all that apply.
 Bridge Builders® Collaborate Gandhi-King Youth Conference YOUnified Youth Ignite Memphis other no
Did you attend Bridge Builders Summer Conference in 2017?






Current Grade:












What medications does the participant take? (This info will remain private.)

Does the participant currently have any of the following medical conditions? (Click all that apply.)
 asthma diabetes back/neck injuries recently broken bones seizures heart condition pregnancy allergies to bee stings hypoglycemia dizziness/vertigo other none
If you click on any condition above, please briefly explain:

Please explain any other medical concerns that may affect your level of participation in physical activity.

Do you have any dietary restrictions or food allergies (vegetarian, kosher, etc.)? If so, please list:

Help us spread the word about #YOUnified17! Please enter the mobile numbers of friends you'd like BRIDGES to invite via text.

For Parent/Guardian: Have you read and agreed to the Bridge Builders Waiver (Click link to read.)? Check the box to confirm that you've read and agree.
Electronic Signature of Participant

Electronic Signature of Parent/Guardian (Required for all minors)

Please answer this simple math question to submit the form.