Entrepreneur Workshop Registration Form

Business Building Workshop
R City Dreams Tour Sign Up: Helping build businesses and connecting participants to their dream jobs

Duration: Fall program is 1 day a week for 5 weeks. Classes start September 28, 2024 every Saturday from 12p-1p
Participant's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade (Type N/A if not applicable):*
Gender*

MaleFemaleOther
Class Availability

Saturdays 12p-2p
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What's the name of the business that we are helping you build?*
What is a goal that you would like to achieve in 5 weeks?*
Cell Number*
E-mail*
example@example.com
Does you have any special needs? If so please provide below
Does the you have any dietary restrictions*

VeganVegetatianPescatarianNo dietary restrictions
Are you taking any medications? If so please list them here
Are you any of the following?*

HomelessUnemployedMigrantOther
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number
Do you have any allergies, chronic illness, or medical conditions? If yes, please describe.
Language
Are there any additional info, questions or concerns youd like to provide?
Informed Consent and Acknowledgement

I hereby give my approval for my participation in any and all activities prepared by E For Everyone during the selected workshop. In exchange for the acceptance of my candidacy by E For Everyone. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless E For Everyone. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to myself, I hereby waive all claims against E For Everyone. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.
Medical Information

I have provided any and all medical concerns or allergies that the staff should be aware of.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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Business Building Workshop

R City Dreams Tour Sign Up: Helping build businesses and connecting participants to their dream jobs