Education Programs Application Form

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Hidden Information
This section will be hidden. The Id below will be populated via the URL; it contains the record Ids we need when pushing the information in this form back to Salesforce.

We'll pull the program and subprogram values from Salesforce, and that will control which sections appear on this application.








Class information





Registration limit reached
Thank you for your interest in this class! The registration limit has been reached, but you or your child will be put on the waiting list.
Waitlist limit reached
Thank you for your interest in this class! Unfortunately, the waitlist limit has been reached and we cannot process additional applications.
Introduction
Thank you for considering the City Parks Learn -- Program. We look forward to receiving your application.
Click the Next Page button below to begin the application.
Parent or guardian information










Participant information










Participant demographic information
City Parks Foundation uses demographic information to better understand the reach and impact of our services.











Staff, interns, and volunteers



Interns





e.g., 3:00 PM, 4:30 PM, etc.








Referral
Please ask one teacher or a group leader that you are affiliated with to provide their contact as recommendation for the internship.



Education experience




Emergency contact details



Medical information 

Yes No


Yes No


Please use the "Add another medication" hyperlink to add each additional medications. 







Consent and authorizations




By submitting this application, I hereby give permission for my child, named above, to participate in CityParks Learn programs. I understand that this program includes field trips to sites other than the daily meeting sites, may include group and community service activities and that I will be provided with advanced notice of each trip location and timing. I give permission for my child to be transported in vehicles driven by trained, licensed and insured City Parks Foundation employees as well as to travel via subway and bus with the program manager and staff members as part of the program curriculum.