World Teachers’ Day Community Walk Registration
Complete the student, parent/guardian, participation, and emergency details, then sign the consent to join the Oct. 9 walk.
Student Name
*
First Name
Last Name
Grade / Class
*
Parent/Guardian Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Will your child be attending?
*
Yes, my child will participate
No, my child will not participate
Who will be accompanying the student?
*
Parent/Guardian
NTA Staff
Other
Number of family members attending with student
*
Emergency Contact Name
*
First Name
Last Name
Relationship to Student
*
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does your child have any medical conditions, allergies, or special considerations that NTA should be aware of during the walk?
*
No
Yes (please specify below)
If yes, please specify medical conditions, allergies, or special considerations
Photo/recording permission: I grant permission for my child to be photographed or recorded during the event.
*
Grant permission
Do not grant permission
Parent/Guardian Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Registration
Submit Registration
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