S.T.A.R. Program Registration

The S.T.A.R. Program (Skills, Training, and Readiness Program) is designed to equip young people with essential job skills, career exposure, and mentorship opportunities. Complete this registration form to enroll.

Language

Do you speak English well enough to receive services in English?

YesNo

What language do you prefer to communicate in?

Primary language spoken, if other

Parent/Guardian Contact Information

Parent/Guardian First Name

Parent/Guardian Last Name

Cell Phone

Preferred contact method

Phone call	Text
Email

I verify that I am the parent or guardian of the participant and give consent to participate in Sabathani Community Center's programming.

I confirm

Add a second parent or guardian for this participant

Second Parent/Guardian Contact Information

Second Parent/Guardian First Name

Second Parent/Guardian Last Name

Second Parent/Guardian Cell Phone

Second Parent/Guardian Email

Preferred contact method

Phone call	Text
Email

Program Participation Questions

Why are you interested in this program, and what do you hope to get out of it?

Do you need any accommodations to be able to participate in this program?

Waiver

In consideration of my (and/or my child's) participation in this activity, I hereby release and discharge Sabathani Community Center, and its representatives, successors, and assigns, from any and all liability arising from accident, injury, and illness that I (he/she/they) may suffer as a result of my (our) participation in this activity.

Initial that you have read and agree to the above waiver.

Photo/Video Agreement

I grant the Sabathani Community Center (SCC) and anyone authorized by SCC to use my and/or my child's photographic images, video and audio with or without my and/or my child's name in SCC promotional materials.

Initial that you have read and agree to the above release.

African/Somali/Ethiopian	American Indian or Alaska Native
Asian	Black or African American
Caucasian	Hispanic/Latino
Middle Eastern or North African	Multiracial
Native Hawaiian or Pacific Islander	Other