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Baltimore Builders Registration

Baltimore Builders Registration2024-03-29T12:16:06-04:00

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Step 1 of 5 - Your Information

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Your Information

Do you check your email often?*
Address*
MM slash DD slash YYYY
Gender*

Race*
National Origin*
Do you have any physical limitations?*
Do you have any food allergies?*

Education

Are you currently enrolled in a Baltimore City High School?*
What school do you attend?*

Interests

What skill/trade are you interested in?*
Please check all that apply
MM slash DD slash YYYY

Emergency Contacts

Emergency Contact 1 Name*
Emergency Contact 1 Gender*

Emergency Contact 1 Address*
Emergency Contact 2 Name*
Emergency Contact 2 Gender*

Emergency Contact 2 Address*
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.
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.
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.
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.
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Tel: 667.653.1982
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Please contact Michael Dorsey at michael@growhomebaltimore.com or (410) 491-0852 to sponsor this event

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