After School Arts – Registration Form – Sharon & Newburgh Elementary – Spring 19

  • Student Information

  • Class Options 4pm - 5pm

  • Class Options 5pm - 6pm

  • Parent/Guardian Information

  • Child's Health Information

  • Payment

    The payment for Foundry After School Arts will consist of monthly payments of $100 for the full 16 weeks. Should you elect to stop classes you must submit your request in writing to The Foundry Center for the Arts. You must submit your online registration by Friday, January 11, 2019 to secure your child’s spot. A separate registration form must be filled out for each student your are registering. A separate Transportation Form must be submitted to your child's school for permission to ride our bus transpiration from school to the Foundry.
  • Child's Medical Consent

    (I) (We) the undersigned, parent(s)/guardian(s) of the registrant above, a minor, do hereby authorize the adult sponsors of the Foundry Center for the Arts, as agent(s) for the undersigned, to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care, which is deemed advisable by, and is required to be rendered under the general or special supervision of, any physician or at the hospital or other health care facility. It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, and is given to provide authority and power on the part of the aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment, or hospital care which may be determined by a physician or surgeon, as aforesaid, to be advisable in the exercise of his/her best judgement. By typing my name below, I am signing this agreement.
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  • Crowd Release Notice

    This notice serves to announce that filming, taping, and or photography will take place at the Foundry Center for the Arts during Foundry After School Arts. By entering our campus, you grant the Foundry Center for the Arts the right to photograph you and your dependent children, to record your voice and to use your likeness without compensation. You also agree to release the Foundry Center for the Arts from any liability in connection with the taping/video production in perpetuity. Video and still images produced from Foundry After School Art’s Activities may be used by The Foundry Center for the Arts in print publications (e.g. flyers, brochures) or video productions. Video and still images may be posted to the Foundry Center for the Arts website. By entering the Foundry Center for the Arts campus, you agree to allow your image to be used for these purposes.
  • Date Format: MM slash DD slash YYYY
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