2024-25 CYL Registration

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BECOME A
CLIMB YOUTH LEADER

2024-2025 CLIMB Youth Leaders Registration

Participating Students and Parents:
Please complete the form below. We look forward to connecting with you!

Student Section (This Section asks questions about the Student Participant)

Student First Name

Student Last Name

Phone

Mailing Address

City

Region/State/Province

Postal / Zip code

Student Age

Date of Birth

Student Grade

Name of School

Participant's Gender Indentity

You may write in your gender identity if it is not listed above:

Ethnicity (The following demographic question is optional but helpful to CLIMB™ for funding and research purposes.)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other

If other please specify below

Have you previously participated in a CLIMB program? (Check all that apply)

SME: Stock Market Experience

CLIMB Youth Leadership Program

CBIE: Community Based Investment Enterprise

Go4It!

Other:

None

How did you hear about the CLIMB USA? (Please let us know the name of the person or organization who referred you.)

Please list the name of any other financial education programs that you have been or are a part of.

What are your Career Aspirations?

Parent/Guardian Section (a Parent or Guardian should answer the questions in this section).

Parent/Guardian First and Last Name

Parent/Guardian Phone Number

Parent/Guardian Email Address

Parent/Guardian Mailing Address

Parent/Guardian Relationship to Child

(Required) I agree to the Collection of Personal Information Online Policy.*

(Required) I agree to thePrivacy Policy.*

(Optional) I hereby consent and authorize CLIMB™ to use the name, image, and voice of my child for CLIMB™ promotional materials. SeeAuthorization for Use of Name, Image & Voice

Parent/Guardian signature (Please provide your signature by typing your full name on the line below. By typing your name, you are agreeing to the terms and conditions outlined above.)

Welcome to CLIMB Youth Leaders! Please check your email for some important information regarding the program.

CLIMB - Administrative

608.218.4554

6666 Odana Road, #221

Madison, WI 53719

support@climbusa.org