Sankofa Programs 2024-2025
PARENTAL / GUARDIAN CONSENT AND REGISTRATION FORM
                                                    ASP- September 3, 2024 - June 6 , 2025   3:00pm - 6:00pm
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Email *
Participant's Name *
Parent/ Guardian's Name *
Home Address *
City *
State/Zip *
Home Phone and/ or Parent Cell Phone *
School *
Grade *
Date of Birth *
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/
DD
/
YYYY
Age *
Gender *
Race *
Ethnicity *
Choose which programs you would like to be apart of *
Required
Allergies w/ Medical Info
What medication is the student regularly taking?
Emergency Contact Name *
Emergency Contact Home or Cell Phone Number *
The following person(s) have permission to pick my child up from the program events (Photo ID Required)
By submitting this form, I hereby verify that the above information is accurate. My signature grants permission for my child to participate in the Sankofa Cultural Arts Center, field trips, and activities therein. In giving my permission to participate, I understand that he/she will take part in scheduled practices, performances, meetings, workshops, cultural, educational and recreational programs. I agree to provide transportation for my child to all scheduled activities. I also agree to facilitate and support my child’s timely attendance and participation. I understand that if there is a fee to participate, I am responsible for the monthly payments.
I agree not to hold the Inner City Cultural League of the Sankofa Cultural Arts Center Programs and its members responsible and/or liable for any injuries or illnesses that my child may sustain while in attendance at the sessions of the program. I also agree not to hold the above-named organization, or its members or appointees individually, liable for the loss or destruction of my child’s property.
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