Child's Full Name *

First Name

Last Name

Is your child an active participants of the Great Minds/Armory College Prep Middle School Program? *

Yes

No

Child's Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child's Birthdate *

MM

DD

YYYY

Child's Ethnic Background *

Please select all that apply.

American Indian

Asian

Black

LatinX, Latino or Latina

Middle Eastern or North African

Mixed or Mult-Ethnic

White

Other

Prefer Not to Answer

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: - Children must keep their hands and feet to themselves at all times. - Children must follow all instructions set forth by staff members. - Children must refrain from damaging any property. - Children must refrain from disruptive behavior, fighting, violence of any kind, and inappropriate language. A child may be immediately dismissed from the event 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.

General Consent *

Please Read and Indicate that You Understand * There are inherent risks and potential for injury when participating in programs such as Great Minds, including but not limited to falls, contact with other participants or spectators, conditions on the track or surrounding areas, and physical exertion. My child and I hereby assume all such risks and responsibility for any and all injury, damage or loss that may result from participation in Armory programming, including those risks that result from the negligence of Released Parties and others. I consent to treatment in the event of an emergency or other incident and agree to pay all costs associated with such medical care. 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, Nike, Inc., and all other sponsors of The Armory Foundation and the directors, officers, employees, insurers, volunteers, representatives and successors of all of the foregoing (“Released Parties”), from any and all present and future claims and liabilities of any kind, known or unknown, arising out of my presence or my child’s participation, even if it is due to the negligence of the Released Parties, to the fullest extent permitted by law. I consent to the participation in interviews, the use of quotes, and the taking of photographs or video, use of name, biographical and other data, image, personal property, or any other aspect of my attendance or that 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 by any of the Released Parties and their affiliates and licensees. I also grant the right to the Released Parties to edit, use, copyright, in all media and in any manner and reuse said material for promotional purposes including use in print, on the internet, and all other forms of media without any additional consideration. I understand and agree that I am responsible for my child’s eligibility and/or amateur standing under various associations and the NCAA. Any dispute between me and the Released Parties shall be settled by arbitration administered by the American Arbitration Association under its Commercial Arbitration Rules and the decision of the arbitrator shall be final and binding upon all parties. While at The Armory, my child and I may be exposed to ideas, designs, inventions and other confidential information and my child and I have no rights to any such information. By checking yes below, I authorize The Armory Foundation to send text messages to my cell phone to convey information about programming. I understand that standard text messaging rates may apply to any messages received from The Armory Foundation.

I have read and agree.

6 Week Commitment *

I will not plan any activities or appointments for my child that will interfere with their participation in the Great Minds Summer program, from Monday, July 7th to Thursday, August 14th.