Formulário de inscrição turma Curumins (2 anos)
Depois do sucesso do programa-piloto, realizado no período de 27 de outubro a 8 de dezembro de 2018, estamos dando continuidade a essa turma. Precisamos de 9 alunos inscritos para que a turma se forme. O prazo de matrículas segue o das demais turmas: dia 2 de janeiro de 2019. Em caso de dúvidas, entre em contato por email:
Nome da criança *
Your answer
Sobrenome da criança *
Your answer
Dia do nascimento da criança *
Mês de nascimento *
Ano de nascimento *
Foi aluno(a) do programa-piloto? *
Nome e sobrenome do responsável pela criança *
(de nacionalidade brasileira ou fluente em português, presente nos encontros)
Your answer
Email do responsável *
(principal meio de comunicação sobre os encontros)
Your answer
Telefone do responsável *
(para contatos de emergência)
Your answer
Endereço residencial (rua e número) *
Your answer
Cidade *
Your answer
Estado *
Your answer
Your answer
Tem irmão ou irmã que é aluno(a) da ABRACE? *
Como ficou sabendo deste programa? (escolha uma ou mais opções abaixo) *
Release of liability (in English so spouses and other parties can understand)
I verify that the parent(s) or legal guardian(s) will bear full legal and financial responsibility for this child, including, but not limited to, the obligation to pay for any debts he or she may incur, damage to property caused by this child, and separate transportation home in the event it becomes necessary. I further verify that I will support the rules and boundaries set by the teachers and leaders who work with our child on behalf of ABRACE, Inc. I recognize that certain activities involve some risk, and hereby indemnify, agree to hold harmless and to release the Fairfax County Public Schools, the McLean Baptist Church and ABRACE Inc, its members, officers, employees, representatives, and agents including any and all volunteer leaders, and each of them, from any liability for any and all past, present or future claims or causes of action for personal or bodily injury or property loss arising out of any ABRACE’s sponsored youth activities that are not due to the negligence of ABRACE’s staff or volunteer leaders. *
Release of photo and video (in English so spouses and other parties can understand)
Pictures or videos are mostly for internal use, and whenever we post images on social media, we never mention names.
I do hereby consent, on behalf of myself and my child, to the photographing of myself and my child. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage and includes oral and video recordings. I agree that ABRACE Inc. may use such photographs of me or my child without my name or the name of my child, and for the sole purpose of conducting all promoting of ABRACE’s educational and cultural activities (including advertising or promoting its programs on its website or other media). I authorize ABRACE Inc. and all its non profit successors in interest to copyright, use and publish the same in print and/or electronically solely for the purpose authorized in this release. I waive any right to inspect or approve the finished product, including written copy, that may be created in connection therewith. I also agree that this releases ABRACE Inc. and any and all of its representatives from any and all monetary obligations or payments to me or any or all of my authorized representatives for use of video, films, photographs, image and/or voice of myself. I am the parent/legal guardian of this child and understand that by filling this form out constitutes legal signature and consent of this registration form and release form. *
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