Registration form

STUDENT INFORMATION
Is your child a new or returning student? *
Student's Name *
Student's Name
Date of Birth *
Date of Birth
Student's Cell
Student's Cell
CLASS INFORMATION
Which classes is your child registering for? *
Does your child take voice lessons? *
Does your child take instrumental lessons? *
INSTRUMENTAL QUESTIONS (ONLY FOR INSTRUMENTAL PROGRAM)
ROCK BAND ONLY: Each Rock Band meets once a week on Wednesdays, Thursdays, Fridays, or Saturdays. Please rank your time slot choices in order.
SCHOLARSHIP AND PAYMENT PLAN INFORMATION
How do you plan on paying for tuition? *
Are you in need of a payment plan? *
Young at Arts offers scholarships to students whose gross family income is below $60,000 or who are under extraordinary financial hardship. In order to take advantage of the scholarship, please submit one of the following, preferably by email: 2017 or most recent tax return, a letter from your employer, or a letter from you stating your family’s current financial hardship.
Will you be applying for a scholarship?
PARENT INFORMATION
Parent 1 Full Name *
Parent 1 Full Name
Parent 1 Cell *
Parent 1 Cell
Parent 2 Full Name (not required)
Parent 2 Full Name (not required)
EMERGENCY CONTACT INFORMATION
Emergency Contact Full Name *
Emergency Contact Full Name
Emergency Contact Phone *
Emergency Contact Phone
NEW FAMILIES
Which new student open house will you and your child attend?
TRANSPORTATION (for Mount Vernon residents only)
The City of Mount Vernon will provide transportation to YAA for all Mount Vernon residents. Please indicate if you will need this service. Pick ups are at school. Drop off at the Doles Center.
Parental Consent / Policies & Procedures
1) All registration forms and tuition must be turned in prior to the start of classes. No student will be allowed in a class with out a registration and initial payment. 2) Students are required to respect building and room in which the classes are being held. Classes are for the enjoyment of your children and, while we do not anticipate misbehavior, we reserve the right to dismiss a disruptive student from a class. Only 3 warnings will be given. After the 2nd warning, the parent will be notified. After the 3rd warning, the student will be dismissed and tuition will be forfeited. 3) There is no nurse on duty during class. If your child requires any special medication, you or an authorized caregiver must dispense medication. 4) Extra rehearsals are anticipated for performances. All extra rehearsals will be broken down according to the needs of the director. The director will give as much advance notice as possible. Your child MUST be able to commit to ALL rehearsals that he or she is called to. 5) Absence Policy: 3 absences (excused or unexcused) are allowed per semester. Please send in all absence excuses in advance to admin@youngatartsny.org. Please review your child’s production calendar carefully before you make a commitment. 6) No absences are allowed during a tech period for a show or final rehearsals for events. 7) There may be a fee for costumes depending on the show, or the show may require that you provide items. 8) No full or partial refunds are given for students' withdrawal or dismissal after first class. I give permission for my student to participate in the Young at Arts program for the 2018-2019 school year. I understand that I am responsible for arranging this young person’s transportation to and from all events (even if dismissed prior to the official end of the event because of unruly behavior). I also give permission for photographs or video of my child to be used by the Christ Church Bronxville or Young at Arts for promotional or other purposes. In case of medical emergency, I understand that every effort will be made to contact the parent or guardian. In the event that I cannot be reached, I hereby authorize and consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any licensed medical personnel on the staff of any licensed hospital. This authorization is given in advance of any specific diagnosis, treatment or hospital care required, but is given to provide authority and power to render care, which is deemed advisable in the best judgment of the physician. I hereby indemnify, agree to hold harmless, and waive any claim against Young at Arts, Christ Church Bronxville, its members, representatives, officers, agents, employees, directors, and each of them, for any and all past, present or future loss to property, and/or bodily injury resulting from any activities engaged.

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Young Voices
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