CURET Virtual Summer Program Registration
Thank you for your interest in having your child/children attend CURET's Virtual Summer Program. Please fill out this form to register.
Name of Student
Present Grade (June 2020)
Prefer not to say
Name of Parent or Guardian
Emergency Contact (Name, Relationship, Address, Phone)
What is the reason for your child's participation in the CURET Virtual Summer Program this year?
Please Read and Sign Below
I hereby agree that all photographs, negatives, prints, paintings, drawings, sketches, reproductions, and likenesses of any kind made of the child are and shall remain the property of CURET. I give my permission that said works may be published, displayed, reproduced, and circulated in any form by CURET, Inc. with or without the child’s name for commercial purposes or otherwise, including advertisement in any media, and with or without any testimonial copy or other form of advertising or display.
As an organization serving children and families, CURET is a mandated reporter.
PARENTAL RELEASE FORM
I, the parent/guardian of the minor child listed on this application, for ourselves, our heirs, executors and administrators hereby release, waive, acquit and forever discharge The Center for Urban Research, Education and Training (CURET), Inc., Hartford School System, their representatives, successors, insurers, assigns or any other person or entity associated with any of the above organizations such as staff, directors or volunteers, from all liability, claims, demands or causes of action for any and all loss, damage injury or death any claim of damages, resulting from use of facilities owned or controlled by the above organizations, or participation in activities of said organizations either at or away from the Program. I understand that CURET is not responsible for lost or stolen items.
By printing my name below, I agree to the terms of the PHOTO RELEASE and the PARENTAL RELEASE FORM.
The four-week Summer Program's tuition & registration fee of $160 has been discounted to $100 per student, and because enrollment is limited, classes are expected to fill quickly. Scholarships are available on a sliding scale and are based on income.
Once you've completed and submitted this online registration form, our staff will contact you to verify your registration information and discuss payment options. CURET is practicing social distancing, please call us at (860) 985-5172 if you have questions, or to schedule a time to meet with us.
Please click the SUBMIT button below and we will contact you with additional details of the CURET Summer Program.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service