Skip to content
HOME
ABOUT US
WHAT WE DO
WORKFORCE DEVELOPMENT
COMMUNITY REVITALIZATION
YOUTH SPORTS & RECREATION
NEWS & EVENTS
NEWS
EVENTS
CONTACT US
DONATE
Facebook
Instagram
LinkedIn
X
YouTube
Baltimore Builders Registration
Baltimore Builders Registration
2024-03-29T12:16:06-04:00
"
*
" indicates required fields
Step
1
of
5
- Your Information
0%
Your Information
First Name
*
Middle Initial
Last Name
*
Email
*
Phone
*
Do you check your email often?
*
Yes
No
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Date of Birth
*
MM slash DD slash YYYY
Gender
*
Male
Female
Other
Race
*
White
Black /African-American
Latino
Asian
Hawaiian /Pacific Islander
Native American /American Indian
Do not wish to disclose
Other
National Origin
*
African
American
Asian
Central and Latin America
European
Middle Eastern
North American
Oceania
Do not wish to disclose
Other
Other Race
*
Other National Origin
*
Do you have any physical limitations?
*
Yes
No
Do you have any food allergies?
*
Yes
No
What are you physical limitations?
*
What are you food allergies?
*
Education
Are you currently enrolled in a Baltimore City High School?
*
Yes
No
On suspension with plans to return
What school do you attend?
*
Benjamin Franklin High School at Masonville Cove
Patterson High School
Carver Vocational-Technical High School
Other
Grade Level
*
9th
10th
11th
12th
Interests
What skill/trade are you interested in?
*
Please check all that apply
Culinary
Basic Construction
Cosmetology
Workforce 101
Urban Agriculture / Solar Energy
Video Production
Music Production
Money Management
Welding
Civic Leadership Group
Other
Other Interests
*
Is there anything else you'd like us to know?
When can you start?
*
MM slash DD slash YYYY
Emergency Contacts
Emergency Contact 1 Name
*
First
Last
Emergency Contact 1 Relationship
*
Emergency Contact 1 Phone
*
Emergency Contact 1 Gender
*
Male
Female
Other
Emergency Contact 1 Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Emergency Contact 2 Name
*
First
Last
Emergency Contact 2 Relationship
*
Emergency Contact 2 Phone
*
Emergency Contact 2 Gender
*
Male
Female
Other
Emergency Contact 2 Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Student Consent
*
I am willing to participate in the Builders OST Program of my own volition and am doing so at my own risk. I am aware that some trades instruction will involve the use of hand and power tools, and the exertion of body and mind. I am aware of inherent risks association with these activities and agree to conduct myself in a responsible manner to ensure a safe and productive work environment.
I agree
Parental Consent
*
I understand that my child may not participate if they present with COVID-19 like symptoms inclusive fever of 100.4 or higher, nausea and/or vomiting, or fatigue.
I agree
Parental Consent
*
I, the undersigned parent or legal guardian, hereby grant permission for my child to utilize the designated transportation provided by Grow Home Inc. for transportation to and from after-school activities. I understand that this transportation is arranged for the convenience of the students participating in the after-school program.
In consideration of my child's participation, I agree to release, indemnify, and hold harmless Grow Home Inc., its employees, volunteers, and representatives from any and all liabilities, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, or injury, including but not limited to personal injury or property damage, that may be sustained by my child during the course of transportation to and from after-school activities.
I acknowledge that Grow home Inc. will take reasonable precautions to ensure the safety and well-being of my child during transportation. I understand that Grow Home Inc. will not be held responsible for any unforeseen events, accidents, or incidents that may occur during transportation.
I certify that my child is physically capable of participating in the after-school activities and has no medical or health conditions that would jeopardize their safety during transportation. I further understand that this waiver shall remain effective for the duration of my child's enrollment in the after-school program, unless revoked in writing and delivered to Grow Home Inc.
I agree
Parental Consent
*
I hereby give my permission for GROW HOME INC and UNITED WAY OF CENTRAL MARYLAND to use without limitation or obligation, photographs and film footage that may include me for the promotion and programs for the sake of increasing capacity for workforce development efforts and greater equity.
I have explained to my child that while participating in the above-described program they must adhere to the Baltimore City Board of Commissioners' policies, the Chief Executive Officers' administrative regulations, and the Student Code of Conduct. I fully understand and have explained to my child that failure to follow policies, regulations and the Code of Conduct may result in disciplinary actions, including the possibility of being dismissed from the program.
I hereby acknowledge that I have carefully read this Waiver and Registration and am aware that in registering myself or my minor child/ward for participation in the program(s), I am waiving and releasing all claims for injuries myself or my child/ward might sustain arising out of the program(s). I recognize and acknowledge that there are certain risks of physical injury to participants in the program(s) and I agree to assume the full risk of any such injuries, damages, or loss regardless of severity which I or my child/ward may sustain as a result of participating in any of the program(s). I hereby fully release and discharge the GROW HOME INC and its officers, agents, servants and employees from any and all claims resulting from injuries, damages and losses sustained by me or my child/ward, and arising out, connected with, or in any way associated with activities of any of the programs.
I, the undersigned participant agree to these terms of program participation and affirm that I am of 18 years of age or older.
I agree
Child Signature
*
Parent Signature
*
Email
This field is for validation purposes and should be left unchanged.
Page load link
Go to Top