SAY: Confident Voices Storytelling Project Enrollment Form

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We’ve taken our popular and long-running Short Play Project, and re-imagined it for this new online world!

The "Storytelling Project" will be a 12-week program, taking place entirely on Zoom for kids and teens who stutter in NYC and the Tri-state area!

Over the course of our Storytelling Project, young people who stutter ages 8-18 will use their unique voices to play with a diverse spectrum of storytelling methods. In an environment where it is really, really, really ok to stutter, participants will harness their imaginations and creativity to write stories that matter to them, and practice sharing them in a way that feels powerful, playful, fun and exciting. At the end of the 12-week program, their original pieces will be featured and celebrated in our Final Share!

Please fill out the form below to enroll your child in the Storytelling Project:

Email *

List of time-slot options (each participant will choose ONE):

List of program dates:

Participant name (first & last): *

Participant age:

Participant date of birth: *

YYYY

Participant identifies their gender as: *

Female

Male

Transgender

Non-binary

Other

Parent / Guardian Name: *

Relationship to child: *

Contact Number: *

Home address (please include zip code) *

Which Storytelling Project time-slot would you like to enroll your child in? (choose one) *

Thursdays, 4:30-6:00pm EST (start date: Oct 8) - SPACE MAY BE LIMITED

Fridays, 3:30pm-5:00pm EST (start date: Oct 9) - SPACE MAY BE LIMITED

Fridays from 5:30-7:00pm EST (start date: Oct 9) - SPACE MAY BE LIMITED

Saturdays from 4:00-5:30pm EST- SPACE MAY BE LIMITED

My child has access to the following device(s) to use during programming: *

ipad / tablet

laptop

chromebook

phone (with camera & internet capabilities)

desktop computer

my child does not have access to a reliable device

Required

What is the impact of stuttering on your child's life? *

Why is SAY important to your family? *

Do you agree to our Terms & Conditions below? *

Yes

Terms of Agreement

1. Parents must notify SAY if their child will be missing part or all of a SAY program or event at least 24 hours BEFORE the SAY event begins. If your child is sick, will be late to, will leave early from, or will miss a SAY program or event, please contact Director of Confident Voices, Kate Detrick or Artistic Director of Confident Voices, Aidan Sank. SAY Cell Phone: (917)-697-7183.

2. SAY is supported by the community, and its programs are typically offered to its participants for much less than the actual cost of the program expenses. However, at this time, all Confident Voices sessions are being offered FREE (while space lasts).

3. SAY is a positive and safe environment. Accordingly, SAY reserves the right to ask a child to leave the company, in its sole discretion, whose behavior resembles the following: a) excessive violent/disrespectful behavior, b) excessive lateness or absences, c) any possession of drugs, alcohol, or weapons.

4. Attendance problems adversely affect SAY's programs, and ultimately your child's experience in those programs as well. Because of this, your child may be asked to leave the program if they are excessively absent. This decision will be made on a case-by-case basis at the Director and Artistic Director’s discretion.

5. I understand that due to COVID-19 restrictions, the Storytelling Project is an online program, taking place using Zoom Video Communications.

6. Families and individual participants may not make contact with SAY employees via personal cell phones, email, or social media (Facebook, Instagram, Snapchat etc.). If a family wishes to make contact with a specific SAY employee, please contact one of the Directors via email (kate@say.org, aidan@say.org) or phone (917-697-7183).

7. Individual SAY employees are not permitted to accept gifts or monetary tips of any kind from families or participants. If a family wishes to give a greeting card or thank-you note to a specific employee, the card may not be presented directly to the employee, but can be given to one of the Directors to be passed along. In addition, express agreement from one of the Directors must be obtained in advance if a family wishes to provide any edible items to share with SAY participants and/or staff.

8. For good and valuable consideration we hereby consent to and authorize the reproduction, publication and use by SAY of any photograph, picture, sobriquet, voice or likeness of my child.

9. I further give permission and consent that any such photographs may be published and used by SAY and the American Camp Association® and its agents, to illustrate and promote the participant experience, SAY and its programs, or the American Camp Association.

In accordance with applicable federal laws, SAY provides equal opportunities to employees and applicants without regard to age, race, religion, ethnicity, veteran status, disability, gender identity, or sexual orientation.