Adult Program Form

  • I understand that the participation in a Roxbury Innovation Center program is voluntary and the program is being offered to students throughout the year as strictly a not-for-profit educational opportunity through the Venture Cafe Foundation.

    As the parent or legal guardian of the aforementioned applicant, I am releasing the Venture Cafe Foundation, their partners and their representatives or affiliates from any wrongdoing during the course of this workshop. This includes any additional costs (including but not limited to transportation, food, beverages, materials, etc.) as well as personal or bodily harm accrued through participation in the Roxbury Innovation Center (RIC).

    In addition, I realize the program is a subsidized workshop offered by the Venture Cafe Foundation in order to provide an invaluable, hands-on educational experience for to students. Hence, I agree to pay any required participation fee or forfeit an opportunity to participate in the program.

    Further, I understand that if a student is found to be disruptive to the learning environment during the course, they will be asked not to return, continue, and complete any current or additional sessions and no refund will be given.

    I also grant permission to the Venture Cafe Foundation, and their affiliates to film and otherwise document the aforementioned applicant's participation for promotional and commercial purposes.

    By typing my legal full name in the box below, I acknowledge and accept all of the above terms as well as stated.

    If the participant is a minor, the legal Parent or Guardian must type their full name in the box below.