E-Academics

About this program

E-Academics is a fully inclusive, sensory-friendly, study space where high school and college students with typical and special needs can learn basic study skills that will help them in their academic journey. Looking forward to growing and learning together.

Get Connected

Sunnyvale E-Academics

Spring 2023 Season

TBD March 2023

Times

TBD

Coordinator

Stephanie Koo (skoo@e-life.org)

Location

Common Ground Courtyard (1050 W Remington Dr, Sunnyvale, CA 94086)

E-Life Sign-up and Waiver

Participant name(Required)

First Last

Parent Name (if participant is a minor)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

(only used for emergency contact purposes only)

Program you're signing up for (check all that apply)(Required)

E-Photography Sunnyvale

E-Gardening Foster City

E-Gardening Sunnyvale

E-Theater Sunnyvale

E-Academics Sunnyvale (18+)

E-Gaming San Carlos

Has your child participated in a group activity program before?(Required)

Yes

Does your child have a “special need” or a medical diagnosis (e.g., allergies, asthma, hemophilia, heart condition, history of respiratory illness, or other significant medical condition, etc.) related to their ability to participate in any E-Life program that the program officials should be aware of?*(Required)

Yes

If yes, please explain in detail:

Please select any of the following conditions that may apply to the participant (you or your child):(Required)

ADD/ADHD

High functioning Autism or Asperger's Syndrome or PDD/NOS

Moderate to Severe Autism

Down's Syndrome or other Developmental disability

Cerebral Palsy

None of the above

Other

Please describe or list:

Please indicate the percentage of one-on-one instruction you feel your child will need to successfully participate in a group program:*(Required)

0--25% (Child can follow direction of coach with little to no individual assistance)

25--50% (Child is fairly independent in following instructions but may need some extra assistance. For example, has difficulty with transitions or needs help with balance at times)

50--75% (Child needs a coach directly assisting or monitoring them over half of the time)

75--100% (Child needs either a coach directly assisting or monitoring them almost all or all of the time)

Notes/comments:

Consent(Required)

I agree to the waiver

ASSUMPTION OF RISK: I, the undersigned parent or legal guardian of the participant, a minor, for myself and on behalf of the participant, our heirs, assigns and next of kin, acknowledge that participation in the E-Life Program activities or events involves risk of physical injury or sickness from infectious disease and possible death. For myself, and on behalf of the participant, our heirs, assigns and next of kin, we willingly and voluntarily accept and assume all such risk. WAIVER, RELEASE AND INDEMNIFICATION: In consideration of E-Life Program permitting the voluntary participation of the participant in its programs, I, the undersigned parent or legal guardian of the participant, a minor, for myself and on behalf of the participant, our heirs, assigns and next of kin, hereby waive all claims and release, discharge, agree to hold harmless and indemnify the E-Life Program, its board of directors, officers, employees, volunteers, officials, sponsors and other representatives from any and all actions, claims, costs, expenses and demands of every kind and description including, but not limited to, personal injury, sickness, property damage and death, based on negligence, contract claim or other legal theory, arising out of, during or in any way related to the minor participating in E-Life Program activities or events. PERSONAL INFORMATION - CONSENT, WAIVER AND RELEASE: I, the undersigned parent or legal guardian of the participant, a minor, for myself and on behalf of the participant, our heirs, assigns and next of kin, hereby consent and give permission to the E-Life Program to take and compile program related photographs, film, video and/or audio clips of the participant and to use them, along with my name and/or the name of the participant, as well as program related personal information about myself and/or the participant, in any printed material, film, video, audio or other medium, including CD, Internet or other electronic media, describing, advertising or promoting the E-Life Program. In consenting to such uses, we hereby waive the right to inspect and approve the images and information used, as well as all rights to compensation. We further release the E-Life Program from any and all claims regarding use of the images or information, including, but not limited to, claims related to defamation, invasion of privacy, or infringement of moral rights, rights of publicity or copyright. I HAVE READ THE ABOVE ASSUMPTION OF RISK, WAIVER, RELEASE AND INDEMNIFICATION AND PERSONAL INFORMATION -CONSENT, WAIVER AND RELEASE, AND I FULLY UNDERSTAND THE TERMS OF EACH. I FURTHER UNDERSTAND THAT THE PARTICIPANT AND I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY MY SIGNING THIS FORM AND AGREEING TO THESE TERMS. I AM AWARE THAT THIS FORM IS A LEGALLY BINDING AND ENFORCEABLE AGREEMENT, AND I SIGN THIS FORM AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY, WITHOUT INDUCEMENT FOR MYSELF, AND ON BEHALF OF THE PARTICIPANT.

Sign me up for newsletter(Required)

Sign me up for E-Life newsletter

Find out more about our programs and get involved

Office address

1050 W Remington Dr
Sunnyvale, CA 94087

Email

info@e-life.org

Name(Required)

Email (Required)(Required)

Primary Phone

Age(Required)

Which E-Life program are you interested in?

E-Photography: Sunnyvale

E-Gardening: Sunnyvale

E-Gardening: Foster City

E-Academics: Sunnyvale

E-Gaming: San Carlos

Leave us a message(Required)