KidPrint ID Pre-Registration- Wayne Public Library

Sierah Strong for the Community & KidPrint Pre-Registration – Wayne Public Library 5/16/26

Sierah Strong for the Community empowers our youth by providing self-awareness and defense training to boys and girls, ages six to eighteen. Each child who attends this FREE self-awareness and defense training program receives a KidPrint ID, which is a laminated card that features the child’s photo, vital statistics such as height, weight, and hair color, along with a fingerprint to find a missing child. This is essential because your fingerprint NEVER changes! Note: Registering multiple children? Please complete the form separately for each child.

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This field is for validation purposes and should be left unchanged.

Parent/Guardian Name(s)(Required)

Enter as you wish to be listed on KidPrintID

Parent/Guardian Email(Required)

Parent's Phone Number(Required)

Date Of Event(Required)

MM slash DD slash YYYY

Are you updating your child's KidPrint ID?(Required)

Yes

Child's Name(Required)

Please enter first and last name only.

Child's Date of Birth *(Required)

MM slash DD slash YYYY

* Must be at least 6 years old

Child's Weight (lbs.)(Required)

Child's Height (feet only)(Required)

Please enter a number from 0 to 7.

If heights is 4 feet and 2 inches, please enter “4”

Child's Height (inches only)(Required)

Please enter a number from 0 to 11.

If heights is 4 feet and 2 inches, please enter “2”

Sex(Required)

Female

Male

Eye Color – Choose ONE(Required)

Blue

Brown

Green

Hazel

Hair Color – Choose ONE(Required)

Black

Blonde

Brown

Red

Street Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Data Storage & Privacy Consent(Required)

I give my and my child(ren)’s consent.

I do NOT give my and my child(ren)’s consent.

Do you grant consent to Justice for Sierah to keep your name and likeness as well as your child’s name and likeness in the KidPrint database that is only to be used for updating information when a new ID is requested or for law enforcement to use when a child goes missing?

Consent(Required)

I agree to the below disclaimer for Justice for Sierah.

Assumption of Risk, Waiver of Liability, and Consent

In consideration of my and my child(ren)’s desire to participate in seminars, classes, demonstrations, and/or personal training provided by Justice for Sierah / Sierah Strong Program, I, the undersigned, intending to be legally bound, do hereby agree as follows:

I understand that participation in self-defense training and related activities involves physical contact and inherent risks, including but not limited to minor injuries such as bruises, strains, sprains, or other physical injury. I attest and verify that I have full knowledge of the risks involved in a contact sport or physical training activity and that I and/or my child(ren) are physically fit and sufficiently able to participate.

If I have any doubt as to my or my child(ren)’s physical condition to engage in these activities, I have been advised to seek the advice of a competent physician and to abide by his or her advice prior to participation.

On behalf of myself, my child(ren), my heirs, personal representatives, and assigns, I hereby waive, release, and forever discharge any and all rights and claims for damages, injuries, or losses which I or my child(ren) may have or which may hereafter accrue, including but not limited to those arising from negligence, against Justice for Sierah, the Sierah Strong Program, its instructors, trainers, volunteers, staff, agents, representatives, affiliated partners, and any participating venues, and any other individuals or entities associated with these programs.

I voluntarily assume all risks associated with participation in these activities and accept full responsibility for any injury, loss, or damage that may occur as a result of participation.

As the parent or legal guardian of a participant under the age of 18, I give permission for my child(ren) to participate in these activities and agree to all terms stated in this agreement.

I give my consent for Justice for Sierah / Sierah Strong Program to use photos and/or videos that I and/or my child(ren) appear in for educational, promotional, or informational purposes. I understand that such images may be used in print publications, online publications, presentations, websites, and social media. I understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

I give my consent for Justice for Sierah to maintain my child(ren)’s name and likeness in the KidPrint database, which will only be used for updating identification information when a new ID is requested or for use by law enforcement in the event a child goes missing.

Dress Code: Comfortable clothing – t-shirt, shorts/loose pants (no short-shorts, crop-tops, skirts, jewelry, watches etc.), tennis shoes (no flip flops, crocks, or sandals). Please bring a water bottle.

Sierah Strong for the Community & KidPrint Pre-Registration – Wayne Public Library 5/16/26

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This field is for validation purposes and should be left unchanged.

Parent/Guardian Name(s)(Required)

Enter as you wish to be listed on KidPrintID

Parent/Guardian Email(Required)

Parent's Phone Number(Required)

Date Of Event(Required)

MM slash DD slash YYYY

Are you updating your child's KidPrint ID?(Required)

Yes

Child's Name(Required)

Please enter first and last name only.

Child's Date of Birth *(Required)

MM slash DD slash YYYY

* Must be at least 6 years old

Child's Weight (lbs.)(Required)

Child's Height (feet only)(Required)

Please enter a number from 0 to 7.

If heights is 4 feet and 2 inches, please enter “4”

Child's Height (inches only)(Required)

Please enter a number from 0 to 11.

If heights is 4 feet and 2 inches, please enter “2”

Sex(Required)

Female

Male

Eye Color – Choose ONE(Required)

Blue

Brown

Green

Hazel

Hair Color – Choose ONE(Required)

Black

Blonde

Brown

Red

Street Address(Required)

City(Required)

State(Required)

Zip Code(Required)

Data Storage & Privacy Consent(Required)

I give my and my child(ren)’s consent.

I do NOT give my and my child(ren)’s consent.

Consent(Required)

I agree to the below disclaimer for Justice for Sierah.