Ohana Pods Interest Form

Parent Information
Parent Name*
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Student Information
Please provide your students Name(s) & Grade(s)*
Subjects you're interested in:*
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Photo Release
I agree to the photo and likeness consent
PERMISSION TO USE NAME AND LIKENESS I hereby give 50CAN, Inc. and all of its present and future parents, subsidiaries, successors, assigns, affiliates, licensees and legal representatives the irrevocable right to use my name (or any fictional name), picture, portrait, or photograph in all forms and media, now known or later developed, and in any and all manners, including composite or modified representations, for advertising, trade or any other lawful purposes, and I waive any right to inspect of approve the finished product, including written copy, that may be created in connection therewith. I am of full age. I have read this release and am fully familiar with its contents. This permission shall be effective as of the date signed below and shall be binding on my heirs, representatives, executors, administrators and any other person acting on my behalf or on behalf of my estate.
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Date*
Date Format: MM slash DD slash YYYY
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Parent Information