Welcome! We are excited to have you here to sign up for our Kindness Anywhere. This amazing program is filled with knowledge and skills for social and emotional well-being, and inspires exploration and discovery of gratitude, compassion and kindness. The result will be kids and teens who take better care of themselves and each other!Select Your Club Age Group*CHOOSE GRADE LEVEL2nd - 3rd Grade4th - 5th Grade6th - 8th Grade9th - 12th GradeDates for the programs are as follows. All programs begin at 4:30 PM EST2nd - 3rd Grade 4th - 5th Grade6th - 8th Grade9th - 12th Grade Mondays September 21 October 19 November 16 December 21 January 18 February 15 March 15 April 19 May 17 Tuesdays September 22 October 27 November 24 December 22 January 26 February 23 March 23 April 27 May 25 Thursdays August 27 September 17 October 15 November 19 December 17 January 21 February 18 March 18 April 15 Wednesdays September 30 October 28 November 18 December 16 January 27 February 24 March 31 April 28 Participant Name* First Last Participant Email Participant PhoneParticipant Grade Level*2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeParticipant School NameParent/Caregiver Name* First Last Parent/Caregiver Email* Parent/ Caregiver Phone*Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Photo Release*I grant Kindness Matters 365 (“KM365”) and its representatives permission to use photographs and videos (“images”) of my child taken during KM365 activities and meetings. KM365 intends to share these images to celebrate and communicate the success of KM365 programs. I grant KM365 the rights to the images and understand the images could be used for any use, including but not limited to social media, educational presentations, promotional pieces, news, and that there is no time limit on the validity of this release.I do not give permission for my student to be photographed or video taped.Privacy Statement* I understand that I may not record KM365 meetings in part or whole.I understand that many participants in Kindness Matters 365 clubs are minors. Therefore recording any portion of a club meeting by myself, my child, another family member, or guest present at our location during club meetings is prohibited. This prohibition includes pictures, screen shots, screen sharing, audio and/or video recording, and live streaming or recording through another device and/or service.KM365 is committed to providing valuable programs to help our kids and teens, especially at times like these. Through the donations of those who can, we are providing Kindness Anywhere free of charge this year so all students can be included. Submission of this form indicates permission for my child (participant) to attend the online Kindness Anywhere program sessions.