Entrepreneurs After School

Interest Form

Thank you for your interest in joining us for Entrepreneurs After School. This program runs on Tuesdays from 3 p.m. - 6 p.m starting April 2022. We are accepting students in grade 5 and up. We provide workspace where students can do school work, engage with mentors, and explore and develop creative ideas.

Please fill out this brief form and we will get you started. We look forward to connecting with you!

Student Name

First Name

Last Name

Location (City/State)

Student School

Student Grade Level

Student GPA

Parent/Guardian Name

First Name

Last Name

Mobile Phone

(###)

###

####

Opt in to text message communication?

Tell us more about what interests you about Project G.E.L. and/or entrepreneurship:

Do you currently have a mentor in your life?

Yes

Media Release

I hereby grant unto Project G.E.L. permission to use this/these child(ren)’s, photograph and/or videotaped image or interview for promotional purposes. I understand and agree that Project G.E.L. may use these photos and/or videotaped images or interviews in subsequent school years unless I revoke this authorization by notifying Project G.E.L. in writing. I further grant unto Project G.E.L. permission to permit my child to be photographed, audio/videotaped, or interviewed by the news media or other organizations for program related stories or articles.

Liability Release

We, the participant and the guardian, release and forever discharge and hold harmless Project G.E.L. and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from the activities as a participant, including claims arising out of negligence. We understand and acknowledge that this submission discharges from any liability or claim that we may have against them with respect to bodily injury, personal injury, illness, death, or property damage that may result from the participant’s involvement in their activities.

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