Dream Leaders We Are The Change
Welcome to the Registration page for Dream Leaders We Are The Change; and "The Power of One". Please fill out this form to enroll in the program.
Email *
The Power of One
Parent/Guardian First name *
Parent/Guardian Last Name *
Parent/Guardian Email *
Student First Name *
Student Last Name *
Student Email
School Name
Student Grade Level *
What are you looking to gain as part of WATC?
Clear selection
When are you most available for virtual conference calls?
Afternoon (3-5pm)
Eveneing (5pm-7pm)
Night (After 7 pm)
Are you interested in being assigned a virtual Mentor?
Clear selection
Do you have regular access to... *
How did you find Dreams for Kids? Please provide a referral name, search engine, or media source.
Is there anything else you would like us to know?
Parental Consent *
I understand that my child has signed up to participate in the Dreams For Kids Power of One Campaign. I understand my child has free access to DFK's, virtual, 10-lesson social entrepreneurship curriculum. * If my child is assigned a Mentor, the Mentor will be screened and comply with DFK's mandatory guidelines. *There will be no physical, in-person meeting between Mentor and student without DFK, and the student's parents express permission. *I understand Mentor assignments are subject to availability. *Mentor will provide educational and developmental advice and guidance, and both parties will work together to identify the student's personal and professional goals, as well as developing a plan for achieving those goals. *I understand the purpose of having a Mentor is to provide my child with the opportunity to develop a supportive relationship with an adult and assist in my child's learning and growth. *I will inform my child's teacher and Mentor of any rules or restrictions regarding my child. *My child agrees to attend all scheduled Mentor meetings, be prepared, be on time, and provide Mentor with advance notice of any change in schedule. *My child agrees to participate in a short monthly progress curriculum report. *In the case of a student's illness, accident, or other situation requiring attention, Mentor will immediately communicate with the student's parent/ guardian and take necessary steps to secure medical care. *Mentor will not provide the student with any gifts and will respect the student's strict confidentiality when requested unless the student's health, safety, or welfare is affected. *During the Mentors, approximate 1 hour weekly meetings, the student will turn off his/her phone and disengage from social media and texting, except in emergencies. *I understand and consent to my child's participation in The Power of One GoFundMe online fundraising campaign. *My child can join as an individual or as part of a team, with an objective to raise a minimum of $100 and invite ten friends to join the campaign. *I agree to release, discharge and hold harmless Dreams for Kids and its employees, officers, directors, and coordinators from any liability claims, causes of action, costs, and expenses arising from, relating to, or which may be, or may at any time hereafter become attributable to his/her participation in the Program and Campaign.
Media/Photo Parental Consent *
I hereby authorize and give my full consent to Dreams for Kids to copyright and publish any photographs, videotapes, and film in which my child or I appear while participating in Dreams for Kids events and campaigns. I further agree that Dreams For Kids may transfer, use or cause to be used these photographs, videotapes, or films for any exhibitions, public displays, commercials, art, and advertising purposes, and television programs without limitations or reservations.
Never submit passwords through Google Forms.
This form was created inside of Dreams for Kids. Report Abuse