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Sati School Enrollment Form
Please enter one child per form.
Email address *
Child's First and Last Name *
Your answer
Parent(s) First and Last Name(s) *
Your answer
Birthdate (MM/DD/YYYY) *
Your answer
Grade in school *
Enter your child's grade placement in his/her school for the 2017-18 academic year.
Does your child have any medical conditions or allergies, inclusive of food allergies, that we should be aware of?
Your answer
Does your child have any dietary considerations?
This helps us choose foods for the snack offering and when food might be used in class.
Your answer
Consent and Waiver of Liability for Sati School Participation: *
I hereby give my consent for the above named student to participate in the Sati School of the Mindful Families of Durham, Inc. I, the undersigned, hereby release and discharge the Board, the organizers, staff, and operators of the MFD and the Sati School from all liability arising out of or associated with all school related activities. For the purposes of this agreement, liability means all claims, demands, losses, causes of action, suits or judgments of any and every kind that occurs related to such activities and that results from any cause including the active or passive conduct and/or negligence of the Sati School or MFD.
By typing your name below, you are providing an electronic signature agreeing to the terms of the Consent and Waiver of Liability.
Parent or Legal Guardian's Signature:
Your answer
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