ENROL A YOUNG PERSON

CHILD INQUIRY FORM

Thank you for your interest in registering your child with Big Brothers Big Sisters of South-West Durham.

Please complete the inquiry form below and one of our Mentoring Coordinators will contact you about next steps.

Parent/Guardian Information
Name*
First Last
Email*
City*
What is the best number to reach you at?*
CHILD INFORMATION
Child/Youth's Name*
First Last
Child/Youth's Age*
(must be between 6 and 16 years)
Child/Youth Date of Birth*
Date Format: MM slash DD slash YYYY
Child/Youth Gender*
One-to-One Mentoring Program(s) of Interest
- Big Brother Mentoring (ages 6-14)
- Big Sister Mentoring (ages 6-14)
- Virtual Mentoring (ages 6-14)
Select any programs in which you believe suits your child best. For more information on programs visit the "Our Programs" tab under MENTORING PROGRAMS.
Group Mentoring Program(s) of Interest
- Go Girls (females ages 11-14)
- Hoop Zone (ages 10-16)
- Power Play 2.0 (ages 11-16)
- Switch Gears 2.0 (males ages 10-14)
- The Little Studio (ages 9-14)
Select any programs in which you believe suits your child best. For more information on programs visit the "Our Programs" tab under MENTORING PROGRAMS.
Comments
This field is for validation purposes and should be left unchanged.