Wheelz n Reelz Session Enrollment
Use this form to enroll in upcoming Wheelz n Reelz sessions. This is not general program interest. This form is for selecting specific session dates.
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Wheelz n Reelz Session Enrollment
This form is for enrolling in specific upcoming sessions. If you have not already completed a program interest form, our team may follow up for additional intake information.
Participant First Name *
Participant Last Name *
Participant Email
Participant Phone
Is the participant an adult or youth? *
Participant Date of Birth
MM
/
DD
/
YYYY
School / Organization
Current grade or grade entering
Parent / Guardian Information
Parent or guardian authorization is required for youth participants. If a youth completes this form without a parent or guardian, enrollment may remain pending until authorization is confirmed.
Parent / Guardian Name *
Parent / Guardian Phone *
Parent / Guardian Email *
Parent / Guardian Authorization *
By selecting yes, I confirm that I am the parent, legal guardian, or authorized adult for the youth participant listed on this form. I give permission for the youth participant to attend the selected Family First Initiative session(s), participate in age-appropriate activities, and be contacted through the parent/guardian information provided when needed.
Medical notes, allergies, access needs, or important concerns
Please share anything our team should know to help keep the participant safe and supported during the session.
Which session(s) would you like to enroll in? *
Required
General Participation Consent
By selecting yes below, I understand that Family First Initiative sessions may include group discussion, workshops, leadership activities, literacy activities, financial education, wellness activities, family engagement, outdoor activities, or community-based programming depending on the session selected. Participation is voluntary. I understand that participants are expected to follow reasonable safety instructions, respect staff, volunteers, and other participants, and participate in a way that supports a safe and welcoming environment. I understand that FFi may contact me or the parent/guardian listed about enrollment, reminders, updates, follow-up, and related program opportunities.
General Participation Consent *
Media Authorization
Family First Initiative may take photos, video, audio, or written stories during programs and events. Media may be used for internal documentation, newsletters, flyers, social media, websites, reports, grant materials, community updates, or promotional materials. Choosing no will not prevent participation. If you choose internal use only, media may be kept for internal records but not used publicly.
Media Authorization *
Safety Waiver Acknowledgment
Some sessions may involve movement, group activities, indoor or outdoor activities, public event settings, travel within event areas, biking, fishing, equipment use, or other normal activity-related risks. I understand that risks may include slips, falls, weather conditions, minor injuries, equipment-related issues, allergic reactions, or other unexpected situations. I agree that the participant will follow safety instructions, use equipment responsibly, and notify staff of any medical, allergy, access, or safety concerns. For youth participants, I confirm that the parent/guardian information and emergency information provided are accurate to the best of my knowledge.
Safety Waiver Acknowledgment *
Anything else you want us to know?
Electronic Signature *
Type your full name to confirm that the information provided is accurate and that you agree to the selections above.
Submit
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