iCan Excel 2018 - 2019 Registration
Drop Off: 9:15AM
Program Finishes: 11:00AM

The dates for the 2018-19 programs are:
August 25, 2018
September 15, 2018
October 13, 2018
October 27, 2018 (double month!)
December 1, 2018
January 12, 2019
February 16, 2019

General Information
Parent/Guardian First Name *
Your answer
Parent/ Guardian Last Name *
Your answer
Address Street *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Name of Child *
Your answer
Birthdate *
Your answer
What school does your child attend? *
Your answer
What grade is your child currently in? *
Your answer
What county do you live in? *
Your answer
Are you a member of The Foundation? *
My child will be in attendance for the following classes: *
Required
Payment Options
To participate in iCan Excel Program 2018 - 2019, 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 Angela at Angela.Dasch@DSFFlorida.org
Please choose the option that works best for you: *
If "other" please explain:
Your answer
Consent to Listing in Class Directory
iCan Excel 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 Learning Program 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 Excel 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.
Your answer
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This form was created inside of Down Syndrome Foundation Of Florida.