WOW Acting Class Registration Form- Updated

WOW PAC Acting Class Registration Form

TUESDAYS from 6:30p - 8:00pm | Starting April 12, 2022
Student Information
*

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student Phone Number *
Student Email *
example@example.com
Age *
Gender *

Male Female
School Name *
School Level *
Parent/Guardian Information

For minors (below 18 years of age)
Parent/Guardian Name *

First Name Last Name
Phone Number *
Email *
example@example.com
Relationship *
How do you learn about this class? *

Facebook Twitter Instagram YouTube Search Engine Online Ads Referral Other
STUDENT CONCERNS: Are there any behavioral/reading/developmental/cognitive issues your PAC teacher should be aware of? If so, please list and discuss this with us before classes begin, so we can create a positive learning environment for all the students in the class.
RESPONSIBILITY & IDENTIFICATION
I understand and agree that I have had the opportunity to have this information read to me, explained to me and/or reviewed by whomever I choose – to ensure I fully understand my responsibility in regard to PAC policies.

Classes, Tuition & Late Payments
-       I affirm that I am the person responsible for the payment of the one time registration fee of $25.00 for the student(s) named above.
-       I understand and agree that the cost per class for the student named above is $25.00 per class.
-       I understand and agree that if paid in full, the discounted tuition for the student named above is $75.00 per month.
-       I understand and agree that tuition is not based on the number of classes in a month/session, but on the cost of the class. Therefore, monthly tuition is the same regardless of the number of classes held in each month.
-       I understand and agree that tuition is to be paid on/by the 1st day of each month, regardless of the number of classes I / my child participates in.
- I understand and agree that if my payment is not paid by the 5th day of the month, a five-dollar fee ($5.00) will be added to my bill. Plus an additional dollar ($1.00) per day, following the 5th day of the month.
- I understand and agree that if tuition is not paid by the 15th of the month, I/my child will not be able to attend classes and that spot will be open to the next person on the waiting list.
Student Name *

First Name Last Name
Parent/Guardian Name *

First Name Last Name
PARENT RELEASE FORM

FOR WOW KIDS AND WOW TEENS
Parent Pick-Up Release

WOW Performing Arts Center requires WOW Kids and WOW Teens to wait inside the building for a parent/guardian to pick them up. This is a requirement for the safety of the child. Children may be authorized with parent/guardian permission only to leave without a parent/guardian coming inside to pick them up. Your signature below indicates your authorization for your child to be released without a parent/guardian.
Student Release *

My child has the authorization to be released without parent/guardian My child does NOT have the authorization to be released without parent/guardian
Video / Photo Release *

I hereby grant WOW Performing Arts Center/WOW Productions the right to use photograph(s), video(s) or interview quote(s) of {name}(my child) for the purpose of promoting and/or advertising the benefits of WOW Performing Arts Center/WOW Productions.
Authorization and Release *

My child has my permission to participate in activities related to his/her theatre class offered at WOW Performing Arts Center. I agree to release and discharge the WOW Performing Arts Center/WOW Productions, program and its directors, employees, and volunteers of and from any and all claims, actions, demands, or liability of damage arising from my child’s participation in any classes, programs, events, rehearsals or performances sponsored by PAC.
LATE PICK-UP POLICY (FOR PARENT/GUARDIAN TO COMPLETE)
PAC class sizes are limited to ensure that children receive the attention they need and deserve. When children are not picked up in a timely manner, this creates the need for changes in the following class.

PAC expects children to be picked up within 15 minutes of the end of classes/rehearsals.

If your child is picked up past the designated departure time, a fee of $20.00 for every 15 minutes beyond designated departure time will be charged.
LATE PICK UP POLICY AGREEMENT *

I understand and agree to honor Late Pick-up Policy outlined above.
BEHAVIOR POLICY AND PROCEDURES

WOW PAC offers a special place where individuals can feel comfortable, safe, and non-threatened, exploring and expressing with their personal creativity.

Inappropriate behavior and continual discipline problems cause difficulty for staff and other participants. PAC Inc.'s objective is to deal promptly and fairly with behavior problems.

It is our aim to resolve behavior problems in order to avoid the student’s dismissal from the program. If necessary, the following procedure will be followed:

1. At the first instance, PAC staff will speak directly with the child/individual to correct their behavior and/or resolve the situation.
2. If behavior/situation continues or is not resolved, PAC staff will notify you/the parent/guardian for assistance.
3. Inappropriate behavior that continues will result in dismissal from the program by the PAC Executive Director. PLEASE BE AWARE THAT NO REFUNDS WILL BE GIVEN.
4. Certain extreme negative behavior (physical or otherwise) may warrant an immediate dismissal upon the discretion of the PAC Executive Director.
Behavior Policy Agreement *

I understand and agree / I have explained to my child, and I / my child agrees to honor the Behavior Policy outlined above.
EMERGENCY CONTACT
Emergency Contact 1 Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Emergency Contact 2 Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Doctor Name

Doctor Name Phone
Insurance Company

Company Name Policy Number
Health Issues
Allergies
Class Selection
- Classes meet once a week, on Tuesdays from 6:30pm-8pm.
- Staff and students are prohibited from the use of any profanity of any kind.
- Staff and students are prohibited from use or promoting the use or abuse of tobacco, drugs, and/or alcohol.
- Students should be in comfortable clothing and not physically revealing or provocative.
Payment & Confirmation

Registration Fee *

Registration Fee

$ 25.00 Quantity
Item subtotal: $ 0.00

Monthly Class - Tuesday Monthly Classes will take place on Tuesday 6:30pm - 8pm starting April 12, 2022. (4 Sessions)

$ 75.00 Quantity
Item subtotal: $ 0.00

Single Class - Tuesday Single Pay Classes will take place on Tuesday 6:30pm - 8pm starting April 12, 2022.

$ 25.00 Quantity
Item subtotal: $ 0.00

Enter coupon

Total

$ 0.00

Payment Method *

Credit Card PayPal Other
Signature *

Clear
Date Signed *

Month Day Year
Date
Should be Empty:

WOW PAC Acting Class Registration Form

Student Information

Parent/Guardian Information

RESPONSIBILITY & IDENTIFICATION

PARENT RELEASE FORM

EMERGENCY CONTACT

Class Selection

Payment & Confirmation