Student First name

Student Last name

Parent/ Guardian Full Name

Email

Would you like to schedule a zoom call? (If 'Yes', we will email you to set up a date).

Yes

No

Phone

What is your student's current grade level?

Which Remnant Youth program(s) are you interested in learning more about?

The Remnant Youth Leadership Academy (Grades 6-12)

Remnant Kids (Grades K-5)

The Remnant 3x3 Academy (Grades 4-8)

Select the date your student would like visit for a trial:

*Remnant Kids - Grades K-5 - Wednesdays (8:30a -12:30p)

*3x3 Basketball - Grades 4-8 - Thursdays (10:30a - 1:30p)

*RYLA - Grades 6-12 - Fridays (9:30a - 2:30p)