Your Own Uniqueness Inc. | Presents | ( “Out Of School Time Program”) Pre-Registration Form

Your Own Uniqueness Inc. | Presents | ( “Out Of School Time Program”) Pre-Registration Form

✨✨ Out Of School Time: Entrepreneurship Skills | Financial Literacy | AI Training | Life Skills | & Much More
Out Of School Time Registration 2026 Classes begin Feb. 10th, 2026 Tue. - Fri. Times: (3:30PM- 6:00pm) (Class dates T.B.D via email)!!! (*Once you register you will receive an email confirmation from You.inc@hotmail.com Please complete this quick form & enter your child's information and sign below to confirm you've completed this form in its entirety.

Please Attend OSTP Orientation Thursday Feb. 5th 2026 (2pm-5pm) to find out more Information & complete Registration at The Ponds Learning Center, 15111 Ponds Village Dr. Taylor, MI 48180.

( Important Announcements will be made through your Apartment MGMT Office and / or via email )

There will be an email sent before Feb. 10th to confirm. Thank you!
Parent / Guardian’s First Name
Parent / Guardian’s Last Name
Parent’s Email Address
example@example.com
Please provide a Parent / Guardian Main Contact Name & Phone Number below (Required)
Child’s Name

First NameLast Name
D.O.B
Gender
Ethnicity
Child’s Teacher or Counselor Name
Child’s Teacher / Counselor Email
Please enter your child’s grade below
T-Shirt Size (Write in)
Ex: Youth or Adult
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Share your Social Media Links!
FB, IG, TikTok, Etc
Allergy & Medical Inquiry Statement:

To help us maintain a safe environment, please list any allergies (food, environmental, medication, etc.) or medical conditions we should be aware of for your student. Include known triggers and emergency response instructions if applicable.
Write in Allergies here:
Does your child have your permission to attend Outside Activities or Field Trips with YOU Inc & Partnering Organizations?
Has your child been immunized? (Yes or No)
Do you give our Program Staff permission to administer Emergency Medical and/or treatment? (Yes or No)
Ex: For inside and/ or outside Emergencies
Topical Application Waiver: I give my permission for the Program Staff to administer Emergency topical application for the following below: (Write I Do)
Ex: Allergies, Sunscreen, Insect Repellent, Neosporin, Etc
I understand that Regular Attendance is expected. (Yes or No)
Photo & Media Consent:

My signature below signifies I give permission for my minor child to be photographed and/or recorded by Your Own Uniqueness Inc (YOU Inc) and its collaborating partners during program activities. I understand that these images and recordings may be used for promotional, educational, and marketing purposes related to YOU Inc & Youth Programming, across print, digital, and social media platforms. I waive any right to inspect or approve the finished materials and release Your Own Uniqueness Inc and its partners from any liability related to the use of such media. Please note your signature below signifies you have read the form entirely and give full consent to all listed terms.
Your Own Uniqueness Inc. women and youth Empowerment 501c3 organization serving the Tri-County areas of Detroit.
Y.O.U Inc.’s mission is to empower
youth and women to overcome the barriers of life and still achieve their economic, social, and interpersonal goals through entrepreneurship through the S.T.E.P U.P. Youth and Adult Programs for youth and adults ages 13-18 & 18+ For more ways to learn to support or register go to: www.DrTFord.com or call: Dr. T at (313)-817-8104 using code: “TalkinYou”.
Parents / Students (Write Yes or No) for Step Up Youth Entrepreneur Summer OST Program Interests.
Please understand with your Signature you give YOU Inc Permission to convert this information over to our Final Registration form. Provide the Parent / Guardian Signature for Minors under 18 years old below ( Please Sign & scroll down to submit form).

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Go to Dr T Ford.com to learn more about Y.O.U Inc. OSTP Program

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