EmailMe Form - Swann School of Protocol Registration Form-WINTER

Name of the participant *

First Middle Last

Name of the parent/guardian completing this form. *

First Middle Last

Participants' Current Age, Grade and Date of Birth *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Contact Number *

### - ### - ####

Best Time to Call *

Parent/Guardian's Email *

Please list any allergies and/or, medical, physical, emotional conditions we should be aware of.

SSOP may occasional take photographs and videos of class activities. From time to time, we use these photos and videos for reasonable promotional purposes on our website and/or social media platforms. Please select an option below based upon the following statement: I hereby grant permission to photograph and/or videotape my child's participation in SSOP activities. *

Students will participate in activities that require sitting, standing and walking. I accept responsibility that my child is physically able and willing to participate in class activities. I agree to hold harmless The Swann School of Protocol, Decorum Venture, Inc. Elaine Swann, Ahesha Catalano & Burbank Swann School of Protocol from any and all claims of personal injuries arising out of class activities.

Please provide any other pertinent information that will help us better serve you:

Upon pressing "submit", you will be directed to the payment screen. There is a $50 deposit to hold your child's space. If you need to cancel prior to attendance 50% will be refunded to you. If you have any additional questions, please visit the website or email ahesha.catalano@swannschool.com

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