Basic Membership Price: $100 for 30 days Parent/Guardian #1 First Name - Primary Contact:* Parent/Guardian #1 First Name - Primary Contact is Required Parent/Guardian #1 Last Name - Primary Contact:* Parent/Guardian #1 Last Name - Primary Contact is Required Parent/Guardian #1 Cell Phone - Primary Contact:* Parent/Guardian #1 Cell Phone - Primary Contact is Required Parent/Guardian #1 Email Address - Primary Contact:* Parent/Guardian #1 Email Address - Primary Contact is Required Parent/Guardian #2 First Name: Parent/Guardian #2 First Name is not valid Parent/Guardian #2 Last Name: Parent/Guardian #2 Last Name is not valid Parent/Guardian #2 Cell Phone: Parent/Guardian #2 Cell Phone is not valid Parent/Guardian #2 Email Address: Parent/Guardian #2 Email Address is not valid Participating Child #1 First Name:* Participating Child #1 First Name is Required Participating Child #1 Last Name:* Participating Child #1 Last Name is Required Participating Child #1 Birthday:* Participating Child #1 Birthday is Required Participating Child #1 School Name / City, State:* Participating Child #1 School Name / City, State is Required Participating Child #1 - Grade in 2020-2021: Participating Child #1 - Grade in 2020-2021 is not valid Choose One3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade Participating Child #2 First Name: Participating Child #2 First Name is not valid Participating Child #2 Last Name: Participating Child #2 Last Name is not valid Participating Child #2 Birthday: Participating Child #2 Birthday is not valid Participating Child #2 School Name / City, State: Participating Child #2 School Name / City, State is not valid Participating Child #2 - Grade in 2020-2021: Participating Child #2 - Grade in 2020-2021 is not valid Choose One3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeOther Participating Child #3 First Name: Participating Child #3 First Name is not valid Participating Child #3 Last Name: Participating Child #3 Last Name is not valid Participating Child #3 Birthday: Participating Child #3 Birthday is not valid Participating Child #3 School Name / City, State: Participating Child #3 School Name / City, State is not valid Participating Child #3 - Grade in 2020-2021: Participating Child #3 - Grade in 2020-2021 is not valid Choose One3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeOther Photo Release: With the increasing use of smartphones, digital photography, Zoom and other electronic platforms, and the web, we are sending you this parental consent form to both inform you and request your permission for your child’s photo/image/video to be published in print and digital/electronic communications. At Children for Change photos, videos, recordings, and/or screenshots may be taken by C4C staff, parents and other children and might be used for our website, social media channels, and other communications. It is also possible that photographers from local newspapers or other news outlets will take or use photos/videos/recordings to document the wonderful things happening with Children for Change. The internet is a public domain and Children for Change cannot control who may access or distribute photos from our postings. Children for Change will not identify students by name in any photo we publish, except to the extent that students include their names on their Zoom or other electronic portals that are then recorded or screenshot.:* Photo Release: With the increasing use of smartphones, digital photography, Zoom and other electronic platforms, and the web, we are sending you this parental consent form to both inform you and request your permission for your child’s photo/image/video to be published in print and digital/electronic communications. At Children for Change photos, videos, recordings, and/or screenshots may be taken by C4C staff, parents and other children and might be used for our website, social media channels, and other communications. It is also possible that photographers from local newspapers or other news outlets will take or use photos/videos/recordings to document the wonderful things happening with Children for Change. The internet is a public domain and Children for Change cannot control who may access or distribute photos from our postings. Children for Change will not identify students by name in any photo we publish, except to the extent that students include their names on their Zoom or other electronic portals that are then recorded or screenshot. is Required I give my permission to use my child’s image as stated above. I do NOT give my permission to use my child’s image as stated in the above. C4C Volunteer Agreement: While we and our partners will take all precautions to keep you and your families safe, you assume the risk of participating in all volunteer activities or attending C4C field trips and hold Children for Change and our partners harmless. Particularly with our study of equity and social justice this year, our calendar includes options to attend events that are protests or otherwise engage students and families in events that may be confrontational. Please be sure to prepare yourselves and your families for the possibilities. In consideration of participating in these events, you agree that you understand the nature of the events you participate in and you assume all risks for yourself and your family. You release, waive, discharge, and covenant not to sue Children for Change or its partner organizations. Finally, you agree to indemnify, defend and hold Children for Change harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities related to your participation in the volunteer opportunities and field trips you choose to attend.:* C4C Volunteer Agreement: While we and our partners will take all precautions to keep you and your families safe, you assume the risk of participating in all volunteer activities or attending C4C field trips and hold Children for Change and our partners harmless. Particularly with our study of equity and social justice this year, our calendar includes options to attend events that are protests or otherwise engage students and families in events that may be confrontational. Please be sure to prepare yourselves and your families for the possibilities. In consideration of participating in these events, you agree that you understand the nature of the events you participate in and you assume all risks for yourself and your family. You release, waive, discharge, and covenant not to sue Children for Change or its partner organizations. Finally, you agree to indemnify, defend and hold Children for Change harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities related to your participation in the volunteer opportunities and field trips you choose to attend. is Required I agree to the above Volunteer Agreement terms Has anyone in your family participated in the past with C4C? If so, in what capacity? (Press shift to select more than one answer):* Has anyone in your family participated in the past with C4C? If so, in what capacity? (Press shift to select more than one answer) is Required Yes. My child has participated in a C4C meeting.Yes. We have volunteered with C4C.Yes. We have participated in a C4C event.No. This is our first time participating with C4C. Which part of C4C program are you most excited about? (Press shift to select more than one answer):* Which part of C4C program are you most excited about? (Press shift to select more than one answer) is Required C4C Education - group classes and speakersC4C Action - ie. volunteering in the communityC4C Advocacy - ie. becoming activists for important causes How did you learn about C4C Community Membership?: How did you learn about C4C Community Membership? is not valid C4C Direct Communication School Communication Social Media - Instagram, Facebook or Twitter Other Online Channel - NextDoor, Ronnie's List, etc. Word of Mouth Other Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Have a coupon? Coupon Code: Invalid Coupon Description Amount Basic Membership – Initial Payment $100.00 Total $100.00 PayPal Pay via your PayPal account No val Please fix the errors above
