American Indian Youth Enrichment Summer 2022 Registration

American Indian Youth 2022 Summer Middle School Enrichment Program Registration

2022 American Indian Middle School Youth Enrichment Summer Registration

Student Name

Birthdate

Gender

Grade Completed

Student ID/lunch number

Tribe/Reservation(s)

Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Phone

May we text to this number?

Address

City

State/Province

Zip/Postal

Persons authorized to pick up my child's work

Our funders require the information requested below. All information will be kept confidential.

How many people are in your household?

Annual Household Income

MEDIA RELEASE: I give permission for my child to be in photos or filming sessions of program activities that may be used for Interfaith Action of Greater Saint Paul, their funders, and partnering agencies’ promotion

Yes

PROGRAM EVALUATION & SURVEYS: Interfaith Action of Greater Saint Paul and the Department of Indian Work aims to provide high quality youth enrichment programming. You and your child will be required to complete a survey before and after the program as required by our funding sources. Information collected will be kept confidential. I give my permission for my child to participate in program evaluation and surveys.

Yes

I acknowledge that St. Paul Public Schools, Interfaith Action of Greater Saint Paul, and the Department of Indian Work will not be responsible for any injury that may occur during the program or lost or stolen items. I understand respect and cooperative behavior is expected, and my child is expected to attend the entire length of the program. This signature includes all permissions stated above.

Date

Sign with your full name

American Indian Youth 2022 Summer Middle School Enrichment Program Registration

Our funders require the information requested below. All information will be kept confidential.

Interfaith Action of Greater Saint Paul

Quick Links

Contact Us