Student Registration

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Registration Form for The DataKirk - Data Literacy and Analytics Club

Email *

Student Information

Full Name of Student *

Age *

School *

School Year *

Gender *

Female

Male

Prefer not to say

Parent / Guardian Information

Title *

Ms.

Mrs.

Miss.

Mr.

Dr.

Other:

Full Name *

Relationship to Student *

Contact Mobile Number *

Address *

Emergency Contact

Fill this section out ONLY if the emergency contact is different from the Parent/Guardian details above.

Full Name

Relationship to Student

Mobile Number

Permissions

I give permission for my son / daughter to participate in the DataKirk literacy and analytics club. I relieve the DataKirk, its directors, staff, mentors and volunteers from all responsibility in case of personal injury and /or property damage resulting from behaviour of my child which is contrary to established rules and/or procedures of the DataKirk. I will also be responsible for any personal injusry and/ or property damage cause by the misconduct or negligence of my child *

I agree

At DataKirk, we use G Suite, and we are seeking your permission to provide and manage a G Suite for Nonprofit account for your child. G Suite is a set of productivity tools from Google including Gmail, Calendar, Docs, Classroom, and more. These tools are used by tens of millions of students and teachers around the world. At DataKirk, students will use their G Suite accounts to complete data tasks, communicate with their mentors, and learn 21st century digital skills. Google's privacy policay can be found at this link: https://www.google.com/intl/en/policies/privacy/ *

I give permission for DataKirk to create/maintain a G Suite account for my child

I do not give permission for DataKirk to create/maintain a G Suite account for my child

Required

It is possible on Google classroom to attach a 'guardian' email address to each account which will send a weekly summary email of their actions. If you would like to recieve this weekly summary, plese fill in your email below.

Please read and tick the appropriate statement *

I hereby give permission for my son / daughter / ward to be photographed / videotaped during the DataKirk literacy and analytics club activities for the purpose of promotion and/or for the program own photo collection which may be used to promote the organisation at a future time. I understand that these photographs / videos will be the property of the DataKirk and may be used in flyers, brochures, posters, newspapers, video, social media (i.e. Facebook, Twitter, agency website), and other promotional items that the DataKirk deems appropriate.

I do not grant permission for my son/ward/daughter/ward to be photographed or videotaped by the DataKirk for the purpose of promotion of data literacy and analytics club.

Required

Confidentiallity

All information pertaining to your child and your child's situation is to be kept confidential. "Release of information" form, signed by a parent or guardian, is needed in order to allow the exchange of information with any other outside organisation. The only exception of document or information access without parental permission would be access by the courts, in response to a court order or warrant.

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