Jestin Time LVL 2 Program: Creative Business & Social Media Foundations Program Form

By completing this form, you are applying for your child to participate in the Jestin Time Level 2 Youth Leadership & Community Program.

This program focuses on developing confidence, communication, leadership skills, and an introduction to professional performance and business concepts in a structured, supervised environment.

Participation is voluntary and guided by instructor-led activities.

Parent/Guardian First Name: *

Parent/Guardian Last Name:: *

Phone Number: *

Email Address: *

Student Name: *

Student Age: *

Has your child completed the Level 1 Program or have prior experience in performance/creative activities? *

Yes
No
Some experience (please explain below)

Explanation (Put N/A if Non-Applicable): *

Does your child have any allergies or sensitivities we should be aware of? *

No
Yes (please explain)

Explanation (Put N/A if Non-Applicable): *

Any medical conditions or considerations we should be aware of? *

Is your child comfortable speaking, participating, and engaging in group activities? *

Yes
Somewhat
No

My child has permission to: (Select all that apply) *

Participate in structured performance and presentation activities
Participate in leadership and teamwork exercises
Engage in guided role-play and real-world scenario activities
Use provided materials and training tools

Photo / Media Release *

I give permission for my child to be included in photos/videos for promotional and educational use
I do NOT give permission

Emergency Contact Name: *

Emergency Contact Phone: *

I understand this is a hands-on creative program and agree that my child will participate respectfully and follow instructor guidance. *

I agree

By submitting this form, I agree to the Terms of Service for the "Jestin Time Youth Leadership & Community Program – Level 2" *

Yes

**Terms of Service for the "Jestin Time Youth Leadership & Community Program - Level 2"**

🎪 Thank you for helping build the laughter!

~ Jestin Time, The Laugh Architect ~