MEMBERSHIP CONSENT AND REQUIRED RELEASE INFORMATION - SIGNATURE MANDATORY
I, the parent/guardian of the minor child listed on this application, for ourselves, our heirs, executors, and administrators, hereby release, waive, acquit and forever discharge Big Imaginations LLC Young Entrepreneurs Mentor Program and their representatives, successors, insurers, assigns or any other person or entity associated with any of the above organizations such as staff, directors or volunteers, from all liability, claims, demands, or causes of action for any and all loss, damage, injury or death and any claim or damages resulting from use of facilities owned or controlled by the above organizations, or participation in activities of said organizations either at or away from the Program.
Mentoring Program
I, the parent/guardian of the minor child listed on this application, give permission for my child to participate in Big Imaginations LLC Young Entrepreneurs Mentor Program. I fully understand that the program involves my child spending a minimum of three hours every third saturday of the month on-site at the program with mentors, either staff or volunteers selected from the community.
Surveys and Questionnaires
I, the parent/guardian of the minor child listed on this application, give permission for Big Imaginations LLC to survey my child about his or her experience and behaviors, skills, and attitudes using different types of survey instruments. Survey information and samples are available upon request.
Photos/Media/Intellectual Property
I give permission for my child's picture,video's, or any other graphic depiction or likeness, to be used by Big Imaginations LLC, its programs, and its activities. All originally created material, unless otherwise noted, is the intellectual property of the Big Imaginations LLC Young Entrepreneurs Mentor Program. No material may be copied or used without the express written permission of the Big Imaginations LLC Young Entrepreneurs Mentor Program.
Miscellaneous
I understand that Big Imaginations LLC Young Entrepreneurs Mentor Program is not responsible for lost or stolen items.
I give my permission to Big Imaginations LLC Young Entrepreneurs Mentor Program to share information about the minor child listed on this application with Big Imaginations partners for research purposes and/or to evaluate the program's effectiveness. Information that will be disclosed to Big Imagianation LLC may include the information provided on this membership application form, and other information collected by Big Imaginations LLC including data collected via surveys or questionnaires. All information provided to Big Imaginations and its partners will be kept confidential.
MEMBERSHIP CONSENT
I have read the completed application and this form, agree that membership is governed by the rules of Big Imaginations LLC Young Entrepreneurs Mentor Program, and request that my child be admitted into membership.
By signing this document, I certify under penalty of perjury. that all the information on this application is correct to the best of my knowledge and belief, and I acknowledge that such information is subject to verification by Big Imaginations LLC or its representatives.
YEMP ACCOUNTS
All money not used will be refunded at the end of the program. If a child has to leave the program we ask that the funds be donated to the organization for basic supplies.
We can reserve space for you prior to your $80.00 contribution towards your childs account, however we ask that you make arrangements to contribute the funds prior to to 2nd or 3rd month of being in the program as your child will need inventory to be sucessful in their business.
METHODS OF PAYMENT: Cash, Cash App, Paypal, Credit Cards. Please call us with any questions about placement or registration.
Payments can be made by scanning the code below and entering the amount of your payment that is due.
There is a $3.00 charge for all credit card payments that must be paid at the time of checkout.