Apollinaire Play Lab fall 2021
Class Registration Form
Student's Name:
First Name
Last Name
Art class for ages 6-9, Art class for ages 10-15, Acting for ages 6-9, Acting for ages 10-15, Ballet ages 6-9, Creative Movement ages 3-5, and Hip/Hop Breakdance for ages 6-9 are full. If you'd like to be put on the waitlist, please email apl@aplaylab.com. Class/es:
WAIT LIST Creative Movement, Ages 3-5, Saturdays 9:30-10:15, $125
WAIT LIST Ballet, Ages 6-9, Saturdays 10:30-11:30, $145
Ballet & Musical Theatre Dance 10-15, Saturdays 11:30-12:30, $145
WAIT LIST Art, Ages 10-15, Saturdays 10:30-11:30, $145
WAIT LIST Acting II, Ages 10-15, Saturdays, 12:30-1:30 $145
WAIT LIST Hip Hop Breakdance, Ages 6-9, Saturdays 12:30-1:30 $145
Hip Hop Breakdance, Ages 10-15, Saturdays 1:30-2:30 $145
WAIT LIST Art, ages 6-9, Saturdays 9:30-10:30 $145
WAIT LIST Acting I, ages 6-9, Saturdays 11:30-12:30 $145
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Payment
Will you be
Paying Full Price
Using the EBT Culture Card Scholarship Program (classes are $40 each for the full session)
Applying for Scholarship or Payment Plan (no EBT card)
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Apollinaire Play Lab
Payment
•Please select the classes you are paying for (no EBT card). •If you are paying EBT rate, please select EBT Card for Culture and also select the number of classes you are paying for.
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Creative Movement, Ages 3-5- WAIT LIST
$
Free
Ballet, Ages 6-9 WAIT LIST
$
Free
Ballet and Musical Theatre Dance, Ages 10-15
$
145.00
Hip Hop Breakdance, Ages 6-9- WAIT LIST
$
Free
Hip Hop Breakdance, Ages 10-15
$
145.00
Acting I, Ages 6-9- WAIT LIST
$
Free
Acting II, Ages 10-15- WAIT LIST
$
Free
Art, Ages 6-9- WAIT LIST
$
Free
Art, Ages 10-15- WAIT LIST
$
Free
EBT Card for Culture (please select the number of classes)
$
40.00
Number of Classes @$40 for 10 weeks/EBT Card for Culture
0
1
2
3
4
Total
$
0.00
Credit Card
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Scholarship Application
For families requesting scholarship without an EBT card.
Student's Name:
First Name
Last Name
Amount your family can contribute towards tuition:
Would you like to consider a payment plan?
Please give a brief description of the family's financial situation:
Anything else we should know:
Once your application has been reviewed, we will contact you to confirm the scholarship amount that has been approved and to arrange for payment.
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Program Expectations & Release Form
Apollinaire Play Lab classes are designed for motivated student actors and artists. Participants who are not able to focus their energy on the work of the class and contribute to the progress of the group will be asked to leave the program.
Students are expected to attend all classes, except in the case of illness, exposure to Covid, or presentation of any Covid symptoms.
Please call or email when your child will miss a class due to illness.
Students must be dropped off and picked up before and after class. Students may not wait unattended while other classes are in session.
Photo Release:
Occasionally, we take photographs of students during classes and performances at Apollinaire Play Lab. We may use these images in print publications that we produce, as well as on our website, or on display boards at the studio. Images may also be used for newspaper advertisements or press releases. We will not use personal details of any person in a photographic image without prior specific permission not covered by this consent form. By submitting this form you consent to use of photographic images.
Covid Safety
Masks are required at all times in the Riseman Family Theatre during Apollinaire Play Lab classes. If your child is presenting with any symptoms, they need to not attend. Classes missed due to illness are not counted as absences. Precautions we are taking in addition to mask-wearing include: our staff is vaccinated, frequent sanitation, air purifiers, and hand sanitizer.
Illness:
If a child should become ill while attending the program, the parent or designated emergency contact will be notified immediately. It remains the responsibility of the parent to provide transportation for the child.
Accident:
In case of accident I agree to hold TheatreZone, Inc. dba Apollinaire Theatre Company and Apollinaire Play Lab and its instructors blameless and to refrain from legal action.
I understand that if a participant is unable to participate for any reason, or is asked to leave the program due to unsatisfactory attendance (absent more than 2 classes), tardiness, or disruptive conduct, the class fee will not be returned.
Further, I hold TheatreZone, Inc. dba Apollinaire Theatre Company and Apollinaire Play Lab and its employees in no way liable for any damage sustained to my child or his/her property while participating in the Apollinaire Play Lab Program.
By submitting this form, I accept the terms and conditions of enrollment for my child described above.
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Apollinaire Play Lab
Riseman Family Theatre • Chelsea Theatre Works, 187 Winnisimmet St. Chelsea, MA • apl@aplaylab.com • 617-615-6506 •
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