One Up School-Year Program Application

One Up School-Year Program Application
Thank you for considering One UP. To register for the progra, please complete the registration below.

The fee for the program is $300. This includes all activities within the program.

Financial considerations should not prevent anyone from attending. Assistance may be requested. For more information, contact program director Miguel Molina at oneup@ernescliff.ca.
Applicant First Name
Applicant Last Name
Applicant E-mail
Applicant Mobile Phone
Applicant Birthdate

MonthDayYear
Please check all that apply to your son. Note that we cannot accommodate all conditions.

Other

By submitting this form, I agree to be added to a Parents WhatsApp group for program announcements.
Release
MEDICAL RELSEASE: By entering my name below, I understand that I am signing as a parent or legal guardian of the applicant. In signing, I authorize One UP staff to seek medical assistance for my son, should the need arise.
Signature
MEDIA RELEASE: By entering my name below, I understand that I am signing as a parent or legal guardian of the applicant. In signing, I authorize any photography or videography that includes my son to be used for the purpose of promoting One UP. I understand that such photography remains property of One UP.
Signature
Should be Empty:

Release