The Imagine Early Program, developed
and administered by the Community Foundation of Wabash County, Inc. (Community
Foundation) offers students in grade 4 through 8 the opportunity to earn scholarships
and savings matches to help pay for college and career training after high
school. For work accomplished in school
– setting goals, turning in assignments, learning about career and college options
– students can earn up to $1,000 in scholarships and savings matches.
To earn Imagine Early scholarships and
savings matches, parents must agree to participate in Imagine Early as follows:
AUTHORIZATION FOR RELEASE OF PROTECTED EDUCATIONAL
RECORDS: I authorize Manchester
Community Schools, Metropolitan School District of Wabash County, Wabash City
Schools, and St. Bernard Catholic School, to disclose educational records
regarding my child, as further described below, for the purpose of my child
being eligible to apply for and receive scholarship funds through Imagine Early. The name of the person or class of persons
authorized to receive the information are employees of the Community Foundation
of Wabash County, 220 East Main St, North Manchester, IN 46962. The following protected educational
records (collectively “Minor’s Data”) may be disclosed by my child’s school:
All educational records of my child that establish my child has met the academic
criteria to be eligible for a scholarship award through Imagine Early
administered by the Community Foundation of Wabash County. I am authorizing
this release relating to my child’s educational records to remain valid through
the end of my child’s 8th grade school year. Further, I understand
and agree that Minor’s Data may be used as part of research and evaluation
within this initiative. The research staff will maintain my child’s
confidentiality by not revealing his or her name, but merely the data collected
itself. However, no information about my child will be disclosed to any entity,
person, or company outside the research process.
AUTHORIZATION FOR RELEASE OF COLLEGECHOICE 529 SAVING
ACTIVITY: I authorize the Indiana
Educational Savings Authority (IESA) to disclose information regarding my
child’s CollegeChoice 529 account, as further described below, for the purpose
of my child being eligible to apply for and receive savings matches through the
Imagine Early Program. The name of the
person or class of persons authorized to receive the information are employees
of the Community Foundation of Wabash County, 220 East Main St, North
Manchester, IN 46962. The following
information may be disclosed by IESA: All information related to deposit activity
that establishes my child has met the saving criteria to be eligible for a
savings match through Imagine Early administered by the Community Foundation of
Wabash County. I am authorizing this release relating to my child’s
CollegeChoice 529 account to remain valid through the end of my child’s 8th
grade enrollment in Wabash County schools.
I understand that I can at any time provide written instructions to the
Community Foundation to revoke this authorization. The Community Foundation does not have the
authority to transact, delete, or change any of my account options or settings.
I acknowledge that the Community Foundation of Wabash County is not a financial
advisor and that they have not provided investment advice related to my child’s
CollegeChoice 529 account.
AUTHORIZATION FOR RELEASE OF DEPICTIONS AND WORKS: I
authorize the Community Foundation, Manchester Community Schools, Metropolitan
School District of Wabash County, Wabash City Schools, St. Bernard Catholic
School, CollegeChoice529, State of Indiana, Indiana Education Savings
Authority, and Ascensus Broker Dealer Services, Inc., including each of their
respective affiliates, directors, officers, employees, contractors,
representative and agents, (collectively, “Imagine Early Program Representatives”)
to take photographs, video/audio/sound recordings and interviews (collectively,
“Depictions”) of me and/or the minor child listed in this Imagine Early
Participation Agreement for its lawful use in connection with the Imagine Early
Program including use in any audio or visual work, marketing materials, print
campaigns, posters, commercials, social media, internet sites or any other
media (whether now known or hereafter devised) (collectively, “Works”). I hereby assign fully to the Imagine Early Program
Representatives, all right, title and interest in and to all Depictions and
Works, and accordingly grant the Imagine Early Program Representatives the
right to reproduce, exhibit, display, broadcast and distribute the Works or
Depictions, and all derivative works thereof. I further waive any right to
inspect or approve the use of the Depictions or Works or rights to any
royalties or other compensation arising from or related to the use of the
Depictions or Works, in connection with the use of the Depictions of Works as
described above. I hereby release and hold harmless Imagine Early Program
Representatives from and against any and all losses, claims, penalties,
demands, actions, causes of action, damages, complaints, or liability arising
out of or related to the use of the Minor’s Data, Works, or Depictions of me
and/or the minor child.
I certify that I am the parent or
legal guardian of the minor child listed in the Imagine Early Participation
Agreement. I have read the contents of
this waiver and fully understand its contents, meaning and impact and sign it
of my own free act and will.
I authorize the Community Foundation
to use my and my child’s contact information to send information about Imagine
Early. This communication includes keeping in contact with my child after high
school graduation and up to age 26, to remind them of their Fund balance and to
send instructions on how to request a grant from their Fund to pay for
qualifying post-secondary educational expenses. I understand that I can
unsubscribe or opt out of these communications at any time. I understand that,
from time to time, the Imagine Early Program undergoes evaluation for the
purpose of improving its effectiveness, and that I may be invited to participate
in such evaluations by way of the contact information that I provide.
Revised 4.4.24
