Black Liberation Comic Book Club 2022-2023
FreedomSchool - Toronto presents Black Liberation Comic Book Club 2022-2023.  Please fill out one form per child.  This program is for children aged 6-15.  Children will have one session/month.  Session will take place on the second Friday of each month from 6:00-7:30pm.  Children will be provided with comic books and materials for art activities.  

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Priority of Admission
Tell us about your child - This information is voluntary and will be used to determined priority of admission into Freedom School.  Admission to Freedom School is not on a first come-first serve basis, but is dependant on need.
1. Does your child/youth identify as both Black and gender non conforming or transgender? *
2. Does your family identify as Black and LGBTQ? *
3. If your child/youth were not to attend FreedomSchool, would your family have funds to access culturally responsive programming (ex: dance class, choir etc.)? *
4. Does your family have family experience with state violence and/or police brutality? *
5. Does your child/youth have school experience that you/your child would describe as mostly negative? *
Young Freedom Fighter Information
Tell us about your child.  This information will help us to program for your child and to keep your child safe.
Name (last/first) *
Gender Pronoun *
Date of birth *
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Ontario Health Number *
Home Address (Number, street name, unit #, city, postal code.  Please indicate if your child lives at one address or alternates between 2 addresses).  We will use this address to drop off supplies and materials for your child to do science activities.   *
Doctors name and phone number *
Does your child/youth have any pertinent medical concerns? Ex: asthma, diabetes, sickle cell, epilepsy *
Accessibility
Does your child have physical accessibility needs?  Ex: Can your child navigate steps/playground climbing equipment etc?  Does your child have physical accessibility needs pertaining to dance lessons or sports?
List accessibility needs *
Learning Needs
Tell us about your child's learning needs!
What is your child/youth's cultural foreground? (Ex: Nigerian, Jamaican, Scotian, Bajan, Black American) *
Tell us a bit about your child/youth learns best (Ex: auditory, visual, kinesthetic, hands-on) *
Does your child/youth know how to read independently?  What kind of books do they like to read? *
If your child/youth does not know how to read independently will you be available to support them to read one comic book/month in October, November and December? *
Does your child/youth have experience with learning online?  How does your child typically handle frustrating interpersonal situations? (Ex: crying, tantrum, hitting, walks away, talks it out) *
How are conflicts or behaviour challenges handled at home (Ex: talking it out, time-out) *
Any suggestions that will help us get to know your child/youth and help them adjust to Freedom School *
Parent(s)/Care giver's Information
Tell us about yourself and your child's parent(s)/guardian(s)
Parent(s) or Guardians (family name(s), given name(s) *
Home Phone *
Work Phone (if employed outside home) *
Mobile Phone *
Email address *
Emergency Contacts (Freedom School - Toronto MUST have on file the names of three people who can help out if your child should become ill/injured and we are unable to solve the issue remotely) *
Media
This course will be conducted online using a learning platform called Zoom.  Zoom uses both a mic and video feature.  From time to time we may take photographs or videos of children's work or likenesses for freedom school promotion.  News/TV stations may feature the children at work.  
Do you consent to your child using Zoom - including the video feature? *
 Would you be willing to have your child filmed for internal media (ex: freedom school newsletter, promotion)  Do you consent to internal media being shared on FreedomSchool - Toronto's website? *
Do you consent to internal media being shared on FreedomSchool- Toronto's social media? *
Would you be willing to have your child filmed for external media (ex: TV, radio, newspaper) *
Are you interested in volunteering?  In your answer, please indicate if you have access to a vehicle/drivers licence, as we may need support dropping off materials to families.   *
Family Contribution
FreedomSchool is a fully subsidized programs.  Contributions are voluntary.  
Would you like to make a monetary donation to Freedom School's 2021 program? *
Are there any supplies you would like to contribute?  (Ex: books, paper, art supplies, fans, toys) *
Are there any special talents you would like to contribute?  (Ex: cooking, sewing, art, design, music) *
SAFETY INFORMATION AND WAIVER
You will be required to sign a safety waiver before engaging in FreedomSchool programming online
Any other information you would like to share with us: *
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