Online Application

Public Speaking, Media & Leadership Program · Ages 8–17 · Afterschool, weekly & weekend workshops, spring break week, and our 6-week summer program

Parent / Guardian

Full name

Phone

Student

Child's full name

Child's age (8–17)

Emergency contact (name & phone) (optional)

Allergies / medical notes (optional)

Media Release Permissions

As a media & public speaking program, students may be photographed or filmed during sessions and the showcase. Please indicate what you permit. These are optional — your child can still participate if you decline.

PhotographyI permit my child to be photographed during program activities. Video recordingI permit my child to be filmed during program activities and the showcase. Promotional useI permit photos/video of my child to be used in promotional and marketing materials.

Privacy & Consent

Your information is kept private and used only to process this application and contact you about the program. It is never sold or shared with third parties.

I have read and agree to the privacy policy and confirm I am the parent/legal guardian authorized to submit this application.