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Student Name

Parent / Guardian Full Name

Email *

Mobile Phone Number (for reminders) *

Grade Level

Participation & Media Consent

I give permission for the individual listed on this registration to participate in this Mindboost Inc. event. I also grant MindBoost permission to use photos or video of me, or my child, for educational and promotional purposes.

Please select one:

I am the parent or legal guardian and give consent for my child

I am 18 years of age or older and give consent for myself

Signature

I consent to receive SMS notifications, alerts, and occasional marketing from Mindboost Incorporated. Message frequency varies. Msg & data rates may apply. Text HELP to 617-427-8000 for help or STOP to unsubscribe anytime.

Privacy Policy | Terms of Service

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