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Taste of Independence Program Registration

Tues. August 6, 2024

9:30am-1:30pm



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Is (are) the youth you are registering between the ages of 14 and 18? If no, please contact us at (716) 338-0170

I give permission for the people listed on this registration to have their picture or video taken a the Chautauqua Children's Safety Education Village and to have these photos or videos as a part of a press release, on our website, in any media including Facebook, Instagram and other social media sites, on television, in videos created to display our classes for advertising purposes. I confirm that I am the legal parent or guardian of the child on this application form.