2023 - 2024 Future Filmmakers Afterschool Registration Form

1
Parent's Name* This field is required.
First Name
Last Name
2
Child's Name* This field is required.
First Name
Last Name
3
Child's Grade* This field is required.
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
4
Child's School* This field is required.Please select your child's school from the dropdown menu.
Please Select
Please Select
Stoneview Elementary
Flat Rock Elementary
E.L Bouie Elementary
Fairington Elementary
Marbut Elementary
Shadow Rock Elementary
E.L Miller Elementary
Panola Way Elementary
Leadership Preparatory Academy
5
Child's Homeroom Teacher* This field is required.
6
Parent's Phone Number* This field is required.
Area Code
Phone Number
7
Parent's E-mail* This field is required.
8
Please check to acknowledge each of the statements below.* This field is required.
I, as the parent/guardian aforementioned, give my permission for my son/daughter to participate in Dream Film Academy's afterschool care program.
I, as the parent/guardian aforementioned, understand that although the students will be supervised by (Dream Faculty & Staff), I do assume the risk in my student’s participation in the program.
I, as the parent/guardian aforementioned, acknowledge that I will not seek to have the School held liable in the event that any accident, injury, loss of property or any other circumstance or incident occurs during or as a result of my son’s/daughter’s participation in afterschool program. This release of liability includes accident, injury, loss, or damages to the student, as well as, to other individuals or property which may result from the student’s participation in the event. I hereby release and agree to hold harmless the School, its officials, agents and employees, from any claims arising out of my son’s/daughter’s participation in the program(s).
I, as the parent/guardian aforementioned, allow Dream Film Academy to pick up my son/daughter daily from their enrolled school. I accept any and all risk associated with my child's participation in our transportation program and I hold harmless Dream Film Academy, the School, its officials, agents and employees, from any claims arising out of my son’s/daughter’s participation in the program(s).
I, as the parent/guardian aforementioned, have read and understand and accept all of the statements recited above and accept full responsibility as described.
9
SignaturePlease sign to confirm receipt and understanding of the terms and conditions of your child utilizing Dream Film Academy's authorized transportation methods and attending Dream Film Academy's afterschool program.
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