Waiver/Release for Project L.E.A.D.

A parent/guardian or student participant 18 years of age must complete the waiver/release.

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name(Required)
e.g. Parent, Grandparent, etc.

STUDENT INFORMATION

Student Name(Required)
Must be at least 12 years of age and no older than 18 years of age.
MM slash DD slash YYYY

RELEASE / WAIVER

If none, type "None"
Physical Training / Exercise
The Be About Change leadership program includes weekly age-appropriate bodyweight exercise during the first half of the two-hour session, organized by a qualified instructor. These activities may include, but are not limited to: calisthenics, yoga, walking/running (indoor and outdoor).

Miscellaneous and Questions
Be About Change Team will contact you approximately one week prior to your first session to confirm your attendance.

For questions, please call us at 615-241-0823 or email [email protected]
Media usage, image, and likeness(Required)
I authorize Be About Change, and/or any of its agents to use writings, photographs, video and images of the student named above for marketing and related activities.
Type your full name (this serves as your legal signature).
This field is for validation purposes and should be left unchanged.

HELP YOUNG PEOPLE ACHIEVE

Your donations impact the life trajectories of our community’s children, young adults, and future generations. Your support provides leadership and literacy programming and encourages accountability and community engagement.

Please consider making a recurring donation.