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[\/et_pb_text][et_pb_contact_form email=”admin@fuerzalatinaservices.org, communications@fuerzalatinaservices.org” custom_message=”Participant Information||et_pb_line_break_holder||||et_pb_line_break_holder||First Name | %%FirstName%% |||et_pb_line_break_holder||Last Name | %%LastName%% |||et_pb_line_break_holder||Address | %%participant_address%% |||et_pb_line_break_holder||City | %%Participant_City%% |||et_pb_line_break_holder||Province | %%Participant_Prov%% |||et_pb_line_break_holder||Postal Code | %%Participant_postal%% |||et_pb_line_break_holder||E-mail | %%Participant_email%% |||et_pb_line_break_holder||Phone | %%Participant_phone%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Program | %%Program%% |||et_pb_line_break_holder||BJR dates | %%Condicional_BJR%% |||et_pb_line_break_holder||GTBS Data | %%Condicional_GTBS%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Parent\/Guardian Information||et_pb_line_break_holder||||et_pb_line_break_holder||Under 18 | %%Under_18%% |||et_pb_line_break_holder||First Name | %%Parent_FirstName%% |||et_pb_line_break_holder||Last Name | %%Parent_LastName%% |||et_pb_line_break_holder||Relationship | %%Parent_Relationship%% |||et_pb_line_break_holder||E-mail | %%parent_email%% |||et_pb_line_break_holder||Phone Number | %%parent_phone%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Emergency Contact||et_pb_line_break_holder||||et_pb_line_break_holder||Main Emergency | %%emergency_question%% |||et_pb_line_break_holder||First Name | %%Emergency_FirstName%% |||et_pb_line_break_holder||Last Name | %%Emergency_LastName%% |||et_pb_line_break_holder||Phone Number | %%Emergency_phone%% |||et_pb_line_break_holder||Relationship | %%Emergency_Relationship%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Waivers||et_pb_line_break_holder||||et_pb_line_break_holder||Waiver 1 | %%0waiver%% |||et_pb_line_break_holder||Waiver 2 | %%1waiver%% |||et_pb_line_break_holder||Waiver 3 | %%2waiver%% |||et_pb_line_break_holder||Waiver 4 | %%3waiver%% |||et_pb_line_break_holder||Waiver 5 | %%4waiver%% |||et_pb_line_break_holder||Waiver 6 | %%5waiver%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Terms & Conditions||et_pb_line_break_holder||||et_pb_line_break_holder||Terms 1 | %%termsandconditions%% |||et_pb_line_break_holder||Terms 2 | %%2_termsandconditions%% |||et_pb_line_break_holder||Signature | %%Signature%% |||et_pb_line_break_holder||Consent | %%Consent%% |||et_pb_line_break_holder||Date | %%Terms_Date%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Email Opt-In | %%sign_up%% |||et_pb_line_break_holder||||et_pb_line_break_holder||Survey | %%Survey%% | ” success_message=”Gracias por suscribirte a nuestro programa. 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select_options=”%91{%22value%22:%22Alberta%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22British Columbia%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Manitoba%22,%22checked%22:0,%22dragID%22:1},{%22value%22:%22New Brunswick%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Newfoundland & Labrador%22,%22checked%22:0,%22dragID%22:3},{%22value%22:%22Nova Scotia%22,%22checked%22:0,%22dragID%22:4},{%22value%22:%22Ontario%22,%22checked%22:0,%22dragID%22:5}%93″ _builder_version=”4.16″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Participant_postal” field_title=”C\u00f3digo postal” _builder_version=”4.16″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Participant_phone” field_title=”Tel\u00e9fono” allowed_symbols=”numbers” required_mark=”off” _builder_version=”4.16″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Participant_email” field_title=”Correo electr\u00f3nico” field_type=”email” 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field_id=”parent_email” field_title=”Correo electr\u00f3nico” field_type=”email” conditional_logic=”on” conditional_logic_relation=”on” conditional_logic_rules=”%91{%22field%22:%22under_18%22,%22condition%22:%22contains%22,%22value%22:%22S\u00ed%22}%93″ _builder_version=”4.18.0″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”emergency_question” field_title=”\u00bfQui\u00e9n es el principal contacto de emergencia?” field_type=”radio” radio_options=”%91{%22value%22:%22Lo Mismo %22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Otro%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” conditional_logic=”on” conditional_logic_relation=”on” conditional_logic_rules=”%91{%22field%22:%22under_18%22,%22condition%22:%22contains%22,%22value%22:%22S\u00ed%22}%93″ _builder_version=”4.23.1″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Emergency_FirstName” field_title=”Nombre” conditional_logic=”on” 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field_id=”Emergency_phone” field_title=”Tel\u00e9fono” allowed_symbols=”numbers” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22emergency_question%22,%22condition%22:%22is not%22,%22value%22:%22Lo Mismo Que El Padre \/ Tutor%22}%93″ _builder_version=”4.18.0″ global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”0waiver” field_title=”Por la presente libero a Fuerza Latina Community Services y sus empleados, sirvientes y agentes de cualquier y todo reclamo que pueda ser causado por, o que surja de la participaci\u00f3n de mi\/mi hijo\/tutelado en actividades en Maple Community Center, Mackenzie Glen District Park, Mackenzie Escuela P\u00fablica de Glen, Festival Latino de Vaughan, Ceremonia de Izamiento de la Bandera de la Herencia Hispana, Galas\/eventos de Fuerza Latina, Residencias de Mapleglen y \u00e1reas circundantes o patrocinados por Servicios Comunitarios de Fuerza Latina; excepto cuando el da\u00f1o o lesi\u00f3n sea causado por la negligencia de Fuerza Latina Community Services o sus agentes, funcionarios y empleados que act\u00faen dentro del alcance de sus funciones.” field_type=”radio” radio_options=”%91{%22value%22:%22S\u00ed%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22no%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.16″ form_field_text_color=”#000000″ form_field_focus_text_color=”#000000″ form_field_font=”|300|||||||” form_field_line_height=”1.8em” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”1waiver” field_title=”Entiendo que yo\/mi hijo\/tutelado no debemos intentar participar en ninguna actividad con la que no est\u00e9n familiarizados, sin antes recibir instrucciones. Tambi\u00e9n acepto que yo\/mi hijo\/tutelado debemos cumplir con las pol\u00edticas de Fuerza Latina Community Services con respecto al uso y operaci\u00f3n de sus instalaciones.” field_type=”radio” radio_options=”%91{%22value%22:%22S\u00ed%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22no%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.16″ form_field_text_color=”#000000″ form_field_focus_text_color=”#000000″ form_field_font=”|300|||||||” form_field_line_height=”1.8em” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”3waiver” field_title=”Entiendo que para mantener un ambiente seguro, inclusivo y positivo para todos los participantes, Fuerza Latina Community Services se reserva el derecho de despedir a un participante por cualquier comportamiento que se considere inaceptable.” field_type=”radio” radio_options=”%91{%22value%22:%22S\u00ed%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22no%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.16″ form_field_text_color=”#000000″ form_field_focus_text_color=”#000000″ form_field_font=”|300|||||||” form_field_line_height=”1.8em” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”2waiver” field_title=”Adem\u00e1s, acepto que yo, el abajo firmante, no tengo conocimiento de ninguna enfermedad f\u00edsica, discapacidad u otra raz\u00f3n que pueda causar que mi participaci\u00f3n, la de mi hijo o la de mi pupilo resulte peligrosa para mi salud. Entiendo que al firmar esta renuncia de consentimiento, me permito a m\u00ed mismo\/a mi hijo\/a participar activamente en la actividad como se describe anteriormente.” field_type=”radio” radio_options=”%91{%22value%22:%22S\u00ed%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22no%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.16″ form_field_text_color=”#000000″ form_field_focus_text_color=”#000000″ form_field_font=”|300|||||||” form_field_line_height=”1.8em” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”4waiver” field_title=”Entiendo que al firmar este formulario, doy mi consentimiento para que el video, las fotograf\u00edas y\/o la pel\u00edcula en la que aparezco puedan ser utilizados por Fuerza Latina Community Services, sus cesionarios o sucesores, para promover eventos y programas de Fuerza Latina Community Services. Adem\u00e1s, por la presente consiento que tales fotograf\u00edas, pel\u00edculas y grabaciones realizadas ser\u00e1n de su propiedad, y tendr\u00e1n derecho a vender, duplicar, reproducir y hacer otros usos que deseen libres y libres de cualquier reclamo de mi parte. Este lanzamiento de fotos se utilizar\u00e1 para fotograf\u00edas\/videos tomados en cualquier evento ofrecido por Fuerza Latina Community Services.” field_type=”radio” radio_options=”%91{%22value%22:%22S\u00ed%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22no%22,%22checked%22:0,%22dragID%22:0}%93″ fullwidth_field=”on” _builder_version=”4.16″ form_field_text_color=”#000000″ form_field_focus_text_color=”#000000″ form_field_font=”|300|||||||” form_field_line_height=”1.8em” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”5waiver” field_title=”Nos reservamos el derecho de cancelar el\/los programa(s) en caso de inscripci\u00f3n y\/o asistencia insuficiente. Se proporcionar\u00e1 un reembolso por cualquier programa que Fuerza Latina cancele antes de la fecha de inicio de los programas. 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