24 -25 Men of ICE Leadership Registration

2024-25 Men of ICE Program

Parent Information

Parent Address
Parent Address
City
State/Province
Zip/Postal

Permission to Participate

REQUIRED PERMISSION: Permission to Participate: I hereby give permission for my child to participate in this program. MY CHILD IS AVAILABLE TO ATTEND EACH DATE. Medical Authorization: I authorize the staff of the summer program to seek medical treatment for my child in case of an emergency, and I agree to be financially responsible for any medical expenses incurred. Transportation Authorization: I give permission for my child to be transported to and from program activities or field trips during the summer program. Photo/Video Release: I consent to the use of photographs or videos of my child taken during the summer program for promotional or educational purposes related to the program. Emergency Contact Information: I confirm that the emergency contact information provided is accurate, and I authorize program staff to contact the listed individual in case of an emergency involving my child.

Payment Information

Payment
$
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