Men Beyond Purpose Academy

Mission
Program
Mentors
Get Involved

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Mission
Program
Mentors
Get Involved

Back to Site

Youth Participant Application

Enroll Your Young Man

Lead • Serve • Empower • Impact

Complete the application below to begin the enrollment process. A member of our team will follow up within 2–3 business days.

About 5–7 minutes Ages 10–18 Eustis, Florida

Prefer paper? Download the printable application (PDF)

Application Received

Thank you. We’ve received the application for your young man and a member of the Men Beyond Purpose team will reach out within 2–3 business days.

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01 Child / Participant Information

Full Name *

Date of Birth *

Age Auto-filled

Current Grade *

Home Address *

City *

State *

ZIP *

School *

Child’s Phone Optional — if he has his own phone

Child’s Email Optional

02 Parent / Guardian Information

Parent / Guardian Name *

Relationship to Child *

Phone Number *

Email Address *

Home Address (if different from child’s)

Best Way to Reach You

03 Emergency Contact

Someone other than the parent or guardian listed above.

Name *

Relationship *

Phone Number *

04 About Your Child

Why are you interested in having your child participate in Men Beyond Purpose? *

What are some of your child’s interests, hobbies, or talents? *

Are there areas where you would like your child to receive additional guidance or mentorship?

Select any that apply. These map to our 10 pillars of development.

Faith & Character Financial Literacy Leadership & Communication Health & Fitness Skilled Trades Entrepreneurship Career Exploration Community Service Education & Academics Conflict Resolution Social Media & Technology Respect & Relationships

Anything else about the guidance he needs?

05 Health & Safety

List allergies, medical conditions, medications, dietary restrictions, or other needs we should know about * Required for his safety at events and activities. Write “None” if not applicable.

06 Parent / Guardian Consent

I give permission for my child to participate in Men Beyond Purpose programs, mentoring activities, meetings, workshops, community service projects, and other approved activities. I understand that Men Beyond Purpose is committed to providing a positive, respectful, and safe environment for youth participants.

I have read and agree to the statement above. *

Photo / Video Permission

Men Beyond Purpose may take photographs or videos during programs, events, community activities, and special occasions for organizational, promotional, social media, or community outreach purposes.

Photo and video permission YES, I give permission for my child to be photographed or recorded. NO, I do not give permission for my child to be photographed or recorded.

Electronic Signature

Parent / Guardian Name (Print) *

Date Today’s date, filled automatically

Signature * Typing your name here serves as your electronic signature. It must match the printed name above.

Cancel

Questions? Email us at menbeyondpurpose@gmail.com

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Men Beyond Purpose is a project of Eustis Community Alliance, a registered 501(c)(3) organization.

Men Beyond Purpose is a project of Eustis Community Alliance, a registered 501(c)(3) organization.

© 2026 Men Beyond Purpose Academy. All rights reserved.

Eustis, Florida