Boys State Accommodations Request Form

This form should be completed by the parent or guardian of the delegate.

The form is due by May 1, 2024.

Delegate's Name: Delegate's Name: First Last
Delegate's Email Address:
Parent/Guardian Name: Parent/Guardian Name: First Last
Parent/Guardian Phone Number Parent/Guardian Phone Number - ### - ### ####
Parent/Guardian Email Address:
ACCOMMODATIONS
Does the participant have any food allergies or require a special diet?

Does the participant have any food allergies or require a special diet? The participant DOES NOT have a special food request. The participant DOES have a special food request (please enter below):
Does the participant require any other types of accommodations (audio, visual, etc.)?

Does the participant require any other types of accommodations (audio, visual, etc.)? The participant DOES NOT require other accomodations. The participant DOES require other accommodations (please enter below):