Covid-19 Precautions and Protocols
Pepperell Community Arts follows the current state of Massachusetts guidelines regarding safety protocols for Covid-19.
PCA After School Class Registration
A separate registration form must be completed for each participant and for each individual class.
Class
*
Take the Stage Jr! Session 1 (WED:grade PreK-1, Sept/Oct)
Take the Stage Jr! Session 2 (WED: grade Prek-1, Nov/Dec)
Take the Stage! Session 1(WED:grade 2-5, Sept/Oct)
Take the Stage! Session 2 (WED: grade 2-5, Nov/Dec)
World of Art Session 1 (MON:grade 2-5, Sept/Oct)
World of Art Session 2 (MON: grade 2-5, Nov/Dec)
Performance Workshop (T&TH: grade 3-5)
PCA Undercover: TECH (T&TH: grade 6-8)
STUDENT INFORMATION:
(One student per form)
Student Preferred First Name (please use the name/nickname they would like to be called & written on name tags)
*
Student Last Name
*
Preferred Pronouns
*
she/her
he/him
they/them
Other
Grade (2022-2023)
*
PreK (4 yrs by 1st day of class)
K
1
2
3
4
5
6
7
8
9
10
11
12
Age on first day of class
*
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
Date of Birth
*
-
Month
-
Day
Year
(mm-dd-yyyy)
Name of School
*
Please share any information that will help us provide the best possible experience for your child (include things like: allergies, behavioral challenges, anxiety, etc., or enter "none")
*
Student Cell Number (if none enter all 0's)
*
Student Email (or enter "none")
*
Confirmation Email
Confirm Email
PARENT/GUARDIAN CONTACT INFORMATION:
Adult 1 Name
*
First Name
Last Name
Adult 1 Cell Phone Number
*
-
Phone Number
E-mail that is checked regularly
*
Confirmation Email
Confirm Email
Adult 2 Name
First Name
Last Name
Adult 2 Cell Phone Number
-
Phone Number
Adult 2 E-mail ONLY IF THEY WANT TO BE INCLUDED ON ALL COMMUNICATIONS
Confirmation Email
Confirm Email
Student Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If I have any questions regarding what protocols are in place with regard to Covid-19, or if I would like to know the vaccination status of the class instructor, I understand that I can inquire about this by emailing pepperellclasses@gmail.com
*
I understand
How did you hear about PCA Classes?
*
Please Select
Social Media
Website
School
Word of Mouth
Flyer
Email
Past Participation
Other
**PAYMENT INSTRUCTIONS** After you hit the submit button below, YOU MUST RETURN TO THE PCA WEBSITE/PAGE FOR CLASS REGISTRATION AND CLICK THE PAY NOW BUTTON to make payment online. Registrations without a corresponding payment will not be considered enrolled. You DO NOT NEED A PAYPAL ACCOUNT TO PAY WITH PAYPAL. AT PAYPAL LOGIN PAGE SCROLL DOWN TO GREY BOX THAT SAYS PAY WITH CREDIT OR DEBIT CARD and pay with your preferred card.
*
I understand
Parent/Guardian Signature
*
Name of parent/guardian signing
*
First Name
Last Name
Today's Date
*
-
Month
-
Day
Year
Date
Submit Form
Should be Empty: