iCan Learn 2019-2020 Registration
Drop Off: 8:45AM
Program Finishes: 11:00AM

The dates for the 2019-20 programs are:
September 7
October 12
October 26
November 16
January 18
February 22
February 29
General Information
Parent/Guardian First Name *
Parent/ Guardian Last Name *
Address Street *
City *
State *
Zip Code *
Home Phone *
Cell Phone *
Email Address *
Name of Child *
Birthdate *
What school does your child attend? *
What grade is your child currently in? *
What county do you live in? *
Are you a member of The Foundation? *
My child will be in attendance for the following classes: *
Required
Which option are you signing up for? *
Payment Options
To participate in The Learning Program 2019 - 2020, you have several
payment options. These options are intended to streamline the tuition
collection process and save on administrative overhead. If you have
payment questions or need alternative arrangements or scholarship
information, please include this information in the notes section and
email Erin Goding at Erin.Goding@DSFFlorida.org
Please choose the option that works best for you: *
If "other" please explain:
Consent to Listing in Class Directory
iCan Learn families often request contact information
for other families. To facilitate communication between families
and friendship building between students, each class will receive
its own email directory.

The directory will include parent(s) and child names and the parent(s)
email/phone number. This information will not be shared with any
person or entity outside your class or The FOUNDATION.
Please indicate below your preference for the iCan Learn Class Directory: *
Photo, Video and Research Release Form
Down Syndrome FOUNDATION of Florida and University of Central Florida
gather photos and video of people with Down syndrome, their families and
friends for the purposes of education, celebration, promotion and
awareness. The FOUNDATION and our Learning Program partners also
use such media as content in presentations that teach families and
educators across the nation how to work with children with Down
Syndrome.

The FOUNDATION and UCF will also be conducting research about our
families participation in The Learning Program.

Please read and sign the following release if you are willing to grant us
permission to use photos or videos involving you, your child or family and
or your loved one to be involved in our research.

I hereby grant The FOUNDATION and UCF, their affiliates,
representatives and employees, the right to take and use photographs or
video of me and/or my minor child in connection with the above-identified
purposes.
I am a parent/guardian. I have read the above and fully understand its contents. *
About My Child
Is there any information about your child that you would like to share with
the iCan Learn team? If your child has any special allergies,
behaviors, sensory issues, transition issues, additional diagnoses
(apraxia, autism, etc.) or fears, please take a moment to let us know so
we can work most effectively with your child.
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This form was created inside of Down Syndrome Foundation Of Florida.