CR CEW ATL Summer 2024

Community R.E.S.T.O.R.E. Inc.

Career Exploration Week Application
Parent/Guardian Name

First NameLast Name
Form

Please fill out this form for Community RESTORE's Career Exploration Week. This workshop will take place from June 24-28th 2024 daily from 8:30am-5:00pm at Caribbean Life TV located at 6254 Memorial Dr C Stone Mountain, GA 30083. We are registering for youth ages 12-18. Space is limited. Please call us if you are registering late (btwn June 21-23) Please call or text 470-440-1340 if you have any questions or concerns.
Parent/Guardian Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
Participant # 1

First NameLast Name
Date of Birth

MonthDayYear
Date
Please enter child's t-shirt size. Type a label
Plz list any food allergies e.g. peanuts, dietary restrictions (gluten, dairy or religious) blanks
Career Interests

ConstructionElectrical/SolarAgriculturePhotography, Videography, Drone photographyGraphic ArtsAudio EngineeringFinancial LiteracyTransportationMake-up Artist(Theatre Make-up also)FilmmakingOther
Participant # 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Please enter child's t-shirt sizeType a label
Plz list any food allergies e.g. peanuts, dietary restrictions (gluten, dairy or religious) blanks
Career Interests

ConstructionElectrical/SolarAgriculturePhotography, Videography, Drone photographyGraphic ArtsAudio EngineeringFinancial LiteracyCulinary ArtsTransportationMake-up Artist(Theatre Make-up also)FilmmakingOther
Type your "Other" Career Interest here, if applicable
Participant # 3

First NameLast Name
Date of Birth

MonthDayYear
Date
Please enter child's t-shirt sizeType a label
Plz list any food allergies e.g. peanuts, dietary restrictions (gluten, dairy or religious) blanks
Career Interests

ConstructionElectrical/SolarAgriculturePhotography, Videography, Drone photographyGraphic ArtsAudio EngineeringFinancial LiteracyCulinary ArtsTransportationMake-up Artist (Theatre Make-up also)FilmmakingOther
Type your "Other" Career Interest here, if applicable
Participant # 4

First NameLast Name
Date of Birth

MonthDayYear
Date
Please enter child's t-shirt sizeType a label
Plz list any food allergies e.g. peanuts, dietary restrictions (gluten, dairy or religious) blanks
Career Interests

ConstructionElectrical/SolarAgriculturePhotography, Videography, Drone photographyGraphic ArtsAudio EngineeringFinancial LiteracyCulinary ArtsTransportationMake-up Artist (Theatre Make-up also)FilmmakingOther
Type your "Other" Career Interest here, if applicableblanks
I consent to and give Community RESTORE Inc. and Caribbean Life TV (CLTV), and their affiliates permission to take photographs, images, videos, recordings, quotes, summaries, (collectively called "media" of myself and my child(ren). I further give permission to use and re-use, publish, distribute or broadcast this "media" in any and all promotional, educational, business, advertising and marketing.
Signature

Clear
Read this Assumption of Risk, Release of Claims, Indemnification, and Hold Harmless Agreement carefully and in its entirety. It is a binding legal document.

If you are under the age of 18, this form must be signed by your parent or legal guardian. In consideration of my participation in CR CEW Program and the activities for which I have registered Classes and Fieldtrips, I represent, covenant, and agree as follows: I acknowledge that participating in the Activity involves certain risks and that injuries, death, property damage, or other harm could occur to me or others. I accept and voluntarily incur any and all risks of any injuries, damages, or harm which arise during or resulting from my participation in the Activity, regardless of whether it was caused in whole or in part by the negligence of the Board of Trustees of the Community Restore INC., its officers, trustees, faculty, agents, representatives, volunteers, students, and employees by and through Community RESTORE Inc., Caribbean Life TV (CLTV) and associate instructors(“Released Parties”).I hereby waive all claims against any of the Released Parties for any injuries, damages, losses, or claims, whether known or unknown, which arise during or result from my participation in the Activity, regardless of whether caused on while or in part by the negligence or other fault of any of the Released Parties. I release and forever discharge the Released Parties from all such claims.

I agree to indemnify and hold harmless the Released Parties from all losses, liabilities, damages, costs, and/or expenses, including, but not limited to reasonable attorneys’ fees and other litigations costs and expenses, incurred by any of the Released Parties Community RESTORE INC. , Caribbean Life TV (CLTV) and counselors and instructors as a result of any claims or suits that I, or anyone claiming by, under or through me, may bring against any of the Released Parties to recovery any losses, liabilities, damages, costs, and/or expenses which arise during or result from my participation in the Activity, regardless of whether caused in whole or in part by the negligence or other fault of any of the Released Parties. I am 18 years of age or older and I have carefully and thoroughly read and reviewed this Acknowledgment of Risk and Waiver of Liability. I understand it fully and voluntarily execute it.
Signature

Clear
Should be Empty:

Community R.E.S.T.O.R.E. Inc.

Form