2023-24 ACP High School Program Application

Student's Name *

First Name

Last Name

Student's Birthdate *

MM

DD

YYYY

Student's Ethnic Background *

Please select all that apply.

American Indian

Asian

Black

LatinX, Latino or Latina

Middle Eastern or North African

Mixed/Multi-ethnic

White

Other

Prefer Not to Answer

Student's Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student's Phone Number *

(###)

###

####

Parent/Guardian Full Name *

First Name

Last Name

Parent/Guardian Phone Number *

(###)

###

####

Health, safety, and behavior agreement *

The Armory Foundation is committed to providing a safe, positive, and growth driven environment for all children who participate at The Armory. Please review the following expectations that guide our behavior management when onsite at The Armory. Expectations: - Students must keep their hands and feet to themselves at all times. - Students must follow all instructions set forth by staff members. - Students must refrain from damaging any building property. - Students must refrain from disruptive behavior, fighting, violence of any kind, and inappropriate language. Consequences: First Offense – Warning Second Offense – Removal from track for remainder of session Third Offense – Temporary suspension Fourth Offense – Permanent dismissal Program administrators have the authority to exercise good judgment and apply a greater or lesser consequence than those listed above. A child may be immediately dismissed from the program if their behavior is determined to be detrimental to well-being of others in the program. Immediate dismissal of an entire family may occur in the event of inappropriate behavior of parents at The Armory. Adults are expected to model the desired behavior that is expected of the children. Profanity, threats, or disruptive behavior will not be tolerated. Please discuss the information listed above with your child. We appreciate your efforts and thank you for the continued support in making appropriate behavior a priority for all children.

I agree and understand.

Please read and indicate that you understand *

There are inherent risks and potential for injury when participating in programs such as Armory College Prep, including but not limited to falls, contact with other participants or spectators, conditions on the track or surrounding areas, and physical exertion, and I and my child hereby assume all such risks and responsibility for any and all injury, damage or loss that may result from participation in Armory College Prep. I confirm that my child is physically fit to participate and is not subject to any medical condition that poses any risk of harm to him/herself or others. I, for myself, my child, and anyone entitled to act on our behalf, do hereby release the The Armory Foundation, the City and State of New York and its agencies and officials, and all other sponsors of Armory College Prep and the representatives and successors of all of the foregoing, from any and all present and future claims and liabilities of any kind, known or unknown, arising out of my child’s participation. I consent to the participation in interviews, the use of quotes, and the taking of photographs or video of my child. The text, image(s), and/or video may appear in electronic form on media websites, in corresponding publications, in print or in broadcast. I also grant the right to edit, use, and reuse said material for promotional purposes including use in print, on the internet, and all other forms of media. By signing this form, I authorize The Armory Foundation to send text messages to my cell phone to convey information about Armory College Prep. I understand that standard text messaging rates will apply to any messages received from The Armory Foundation. I also understand that The Armory Foundation may revoke this permission at any time.

I have read and understand.