Official Registration Form

Program Registration & Attendance Sheet

Complete this form to register for any of our free community programs and classes.

Participant Information

Fields marked with * are required

Participant Full Name *

Phone Number *

Email Address *

Emergency Contact *

Program / Class Name *

Facilitator

Date *

Allergies / Medical Concerns

Disclaimer *

I voluntarily agree to participate in programs and activities organized by Nalam Care. I understand that participation involves physical and/or mental activities, and I assume all risks associated with my participation. I release Nalam Care, its staff, volunteers, and affiliates from any liability for injuries, accidents, or damages that may occur during my participation in these programs.

YES, I AgreeNO, I Do Not Agree

Photo & Media Consent *

I grant Nalam Care permission to use photographs, video recordings, and other media taken during programs for promotional purposes, including but not limited to social media, website content, newsletters, and marketing materials. I understand that my image may be used without further notification or compensation, and I waive any right to inspect or approve the finished materials.

YES, I ConsentNO, I Do Not Consent

Participant Signature *

Please sign below using your mouse or finger (on mobile). Date will be automatically recorded upon submission.

Sign here

Date: May 19, 2026

By submitting this form, you confirm that all information provided is accurate. Your data is securely stored and will only be used for program administration purposes.

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