Niara Scholar Application

Education

Parent/ Guardian Information

Child's Hobbies and Special Interest

Reflection (Parent/Gaurdian)

Person to Notity in Case of Emergeny

Niara Academy Authorization & Disclaimer

While is it a virtual platform, I am aware that there are certain risks involved in Project Optimism’s Niara Academy workshops that may result in personal injury or property damage. By willingly participating in all activities, I agree to accept all risks of injury or damage.  I authorize Niara Academy staff to make medical emergency decisions for my child, and I further acknowledge that Project Optimism will not be held liable in any way, including resulting medical charges.  I understand that this agreement is binding to me, my child and anyone else acting on behalf of my child.  I also agree to allow Project Optimism to use videos and photos of me or my child for promotional purposes.  

Gaurdian Approval
Mentee Approval

Niara Academy (Virtual)

Serving Sacramento and Los Angeles County

Contact Us:  admin@projectoptimism.org        

Tax ID: 82-1542836

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