Student Registration Form - Seattle Marathi Shala (2023-2024)
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Email *
Student's Name *
Student Date of Birth 
 *
Student Age in (Yrs and Mnths) *
Level / Class attended last year from Marathi Shala? If Yes mention it *
Parent's/ Guardian's Name *
Address *
Email address and Phone number  *
Any sibling attending the shala ? (If Yes, Please fill in the name) *
Is any parent volunteering at Marathi Shala? Mention the Role. *
Would you be interested in volunteering at Marathi Shala? *
Emergency contact names and numbers (at least 2) *
Are these contacts authorized to pick up your student and release in case of emergency?
 *
Allergies / Food Restrictions *
Student's Health card insurance information
Any medical conditions or medication Shala should be aware of? *

Permission to attend in person classes, school events and activities:

I give permission for my child to participate in 2023-24 school year program at the Seattle Marathi Shala. The program includes learning Marathi language, exposure to Marathi cultural by learning about and celebrating different festivals and events at school.

I give permission for my child to have snacks, food and play games at the organized events of  Marathi Shala. If the child has medical conditions or allergies, one parent must be present on campus while the food is being served.

 *

Mailing list Permission:

I give permission for my child to be put on mailing list to be used for the purpose of Seattle Marathi Shala students programs, such as early release notification, event date/time changes etc.  

 *
Picture/ Video Consent
Do you provide consent to Seattle Marathi Shala for taking  photos and videos of your child and using them for communication with other families, newsletters, flyers and/or Media purposes for promoting Marathi Shala?
 *
Waiver and Release of liability
     Seattle Marathi Shala Volunteers including but not limited to Staff Members,  Event planners and volunteers will not be liable for any injury including but not limited to personal body or mental injury, economic loss or any other damage to you or your children during  in person events.
 *
Consent for Emergency Medical Treatment
    In the event of any medical emergency the undersigned parent or guardian grant permission to Volunteers of Seattle Marathi Shala including but not limited to  Staff Members , event planners and volunteers to order emergency medical treatment for their student. Each of the undersigned also agrees that none of our volunteers including but not limited to teachers, administrators, event planners shall be liable for exercising the foregoing authority in the event of an emergency.
 *

Date: ----------------------------------------------- 


Signature: ---------------------------------------

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A copy of your responses will be emailed to the address you provided.
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