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Parent/Guardian Name

Parent/Guardian Phone Number

Parent/Guardian Email

Leader's Name

Leader's Age

Date of Birth

Grade Level

Leader's Official Language if not fluent in English

Do you want to add another Leader?

Location

Please select the primary reason for signing up your child

Where did you hear about us?

Consent Form

The parent/guardian agree to supervise the child if needed for virtual activities.
For children below 13 years old, the parent/guardian will be responsible for handling, maintaining, and supervising their accounts.
All the lessons, tutorials, and activities will be recorded so that the learners can have continued access to them for one full year.
Media Release: We record our Zoom video conferencing sessions and also take pictures with our speakers so by signing this form, you give us permission to utilize any pictures or videos of your child for archive and promotional marketing purposes only.
Confidentiality: We will handle your/your child's personal information with the utmost confidentiality and will not disclose it to any third parties.
Consent for Future Contact: By agreeing to this disclaimer, you grant us permission to contact you/your child in the future regarding other program-related activities.

I (Parent/Guardian) have read and agree to the terms and conditions indicated in above

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