Enroll for Spark Arts Summer 2022

Sessions *

Week 1 – Bookmaking
Monday, June 27 – Friday, July 1
9:00am–2:00pm
For children aged 5–10
$500.00 ea.
Add
Week 3 – Mosaics
Monday, July 18 – Friday, July 22
9:00am–2:00pm
For children aged 5–10
$500.00 ea. [Sold Out]

For Admin. Use Only

About Your Child

Child's Name

Child's Nickname (optional)

Date of Birth

Please select your child's current grade.

Parent/Guardian Information

Parent/Guardian 1 Information

Parent/Guardian 1 Name

Parent/Guardian 1 Address

Parent/Guardian 1 Mobile Number

Parent/Guardian 1 Email

Please send important program communications to

Parent 1 only
Parent 2 only
Both parents

Parent/Guardian 2 Information

No second parent/guardian

Parent/Guardian 2 Name

Check here if Parent/Guardian 2 has the same address as Parent/Guardian 1.

Parent/Guardian 2 Address

Phone Number

Pick Up Authorization

List the names, relationships, and contact information for any non-parent individuals authorized to pick up your child/children from Spark Arts at the end of the day. We cannot release your child to anyone who is not listed on this form without prior authorization from a parent/guardian.

If registering multiple children, individuals authorized for pickup will be for all siblings.

Persons authorized to pick up your child:

Health and Medical Information

Does your child have any health related conditions? If so, is there any specific care or corresponding medicines that will need to be administered by staff during program hours?

Please list any sensitivities or allergies that your child has, including food and beverages, products (i.e. soaps, lotions, sunscreens), or general conditions like direct sunlight.

Do you follow any dietary practices or restrictions that should be adhered to while your child is at Spark Arts?

Please list up to 3 emergency contacts we can reach out to if parents are unavailable.

Please offer any information that will help our staff care for your child.

Please read our Acknowledgement of Risk form carefully to review new changes to address our Safety Policies around COVID-19, which can be found here.

Acknowledgements

Acknowledgement of Risk

Our absolute highest priority at Spark Arts is to provide a safe environment for the children enrolled in our program. We ask that your family is aware of risks involved in your child’s participation in Spark Arts, and that your family agrees to our behavioral expectations so that we can have an enjoyable and safe environment during our time together.

Our program has put a COVID-19 Safety Policy in place with expectations and guidelines for the behavior of families, children, and staff, which can be read here. By signing this document, I fully understand and agree that my child and I will adhere to these safety policies. I also acknowledge that these policies mitigate but do not fully eliminate the risk of contracting COVID-19, and agree not to hold Spark Arts Studio LLC liable in the event that a participant contracts COVID-19 as the result of participation in any Spark Arts Studio LLC programs.

By signing this document, I fully understand and acknowledge that my child‘s participation in the activities offered by Spark Arts Studio LLC may result in their injury, and/or damage to personal property. I understand that other participants, accidents or forces of nature may cause these risks and I hereby accept this risk. I recognize that Spark Arts is not a licensed childcare program and that 53 Prospect Park West is not a licensed childcare facility.

In order to maintain the safety of the program, I understand my responsibility in preparing my child for behavior that is appropriate, cooperative, safe and will not endanger his/her health and well-being, or the health and well-being of other participants. I recognize that behavior that is considered unsafe, destructive and inappropriate may put my child at risk of removal from the program.

ACTIVITY: Spark Arts: creative arts enrichment program
DATES: June 27, 2022–July 22, 2022

I HAVE READ THE ABOVE AND BY SIGNING BELOW, I AGREE IT IS MY INTENTION TO HAVE MY CHILD PARTICIPATE IN THE INDICATED ACTIVITY AND UNDERSTAND AND FULLY ACCEPT THE RISKS INVOLVED AND RELEASE SPARK ARTS STUDIO, ITS EMPLOYEES, AND AGENTS FROM ANY LIABILITY.

I am the legal parent/guardian authorized to sign this document of the child named herein.

I, the undersigned, agree to the terms above.

Child's Name

Child's Date of Birth

Parent/Guardian Name

Date

Refund policy

Refunds may be issued if classes are canceled by Spark Arts for reasons such as hazardous weather, COVID surges, staff illness, or other unexpected circumstances. If a family should choose to cancel an entire week of programming, we will consider refunds on a case by case basis, taking in consideration the circumstances, the amount of warning given, as well as our ability to fill the spot. We do not refund for absences on specific days of enrolled weeks.

Yes, I agree.*

Scissors and Needlepoint Usage Release

Scissors Release *

I authorize my child to use scissors while at Spark Arts. Although it is an unusual occurrence, I realize that there is the possibility that children can hurt themselves while using this tool.

I have read and agree to the terms above.

Fabric Needles Release *

I authorize my child to use fabric needles while at Spark Arts. Although it is an unusual occurrence, I realize that there is the possibility that children can hurt themselves while using this tool.

I have read and agree to the terms above.

I give Spark Arts Studio LLC my permission to use my child’s photograph for promotional purposes in print and online form. Spark Arts Studio LLC will not identify my child by name or address along with the photos.

Coupon Code

Credit Card fee (waived if paying by check)

$0.00

Billing Information

Name

Payment Method

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