SUMMER PERFORMING ARTS 5678 2025

Performing Arts 5678 SUMMER 2026 Registration Form

Complete this form once for EACH student
PERFORMING ARTS 5678 is excited to continue Summer “Theatre in the Park” experiences! Our outdoor amphitheatre is located on the grounds of VFW Post 6259 (15 Locust Ave., Berkeley Heights, NJ).

Summer programs are held outdoors, breathing the fresh air and soaking up the sun’s Vitamin D, all the while, engaging in the Performing Arts!

Age ranges are based on 2026-2027 school year (ie: 1st - 5th Grade programs are intented for students who will be in 1st - 5th Grade during the 2026-2027 School year.

During inclement weather, the indoor studio will be used.

MINIMUM ENROLLMENT: In the event a program does not meet minimum enrollment, you will be notified two weeks in advance and can choose an alternate program or get a refund.

REFUND POLICY: In the event that you must cancel your student's registration, please see below.

30 DAYS OR MORE NOTICE: Full tuition refund

15 - 29 DAYS NOTICE: 50% tuition refund

7 - 14 DAYS NOTICE: 25% tuition refund

Less than 7 days NOTICE: No refund

Refunds must be requested in writing, via email (performingarts5678@gmail.com). Refunds will be made in the form of a check. If you would like to cancel and receive a refund prior to sessions beginning, you must request via email a minimum and tuition refunds will be given based on the above tiered system. Registration fees are non-refundable. Email: performingarts5678@gmail.com

REGISTRATION FEE: Due within 7 days of enrollment, your the student's spot may not be reserved. A Registration Fee of $30 includes a PERFORMING ARTS 5678 short-sleeved t-shirt. (One Participation Fee per student for the 2025 Season, not per program.)

Upon completion of your Registration Form, within 24 hours you will receive an invoice confirmation via email.

PAYMENT: CASH, CHECK, or ZELLE (Payable to: Performing Arts 5678).
- Mail checks to: Performing Arts 5678, 337 Diamond Hlil Rd., Berkeley Heights, NJ 07922.
- ZELLE: performingarts5678@gmail.com
- APPLE PAY: Text to (646) 221-3150
- CASH: Contact Jessica Lombardi to arrange. (646) 221-3150
- If your payment is not received, then your child's spot may not be reserved.
- *NOTE: If you would like to speak with us about making special payment accomodations, please email: performingingarts5678.com
WAITLIST: If a program is "Waitlist Only", no payment is due unless a spot opens up. If a spot opens up, you will be contacted and can make an acceptance decision. Once contacted, if a decision is not made within 24-hours, the next person on the waitlist will be offered the spot.

PROGRAM DETAILS CAN BE FOUND ON OUR WEBSITE: SUMMER INFO
Student Name (Complete 1 form for EACH student)*

First NameLast Name
Student Age (Age by June 15, 2026)*
What grade will student be in during the 2026-2027 School year?
Student Gender*

MaleFemale
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Cell Phone Number*

Area CodePhone Number
Parent/Guardian Email (Please provide an email you check, as this will be used for correspondence, updates, etc.) *
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email (if they would like to be included on emails / Please Note: School emails often do not allow outside correspondence) (if applicable)
example@example.com
I understand that the $30 Registration Fee is due ASAP (no later than 1 week from enrollment). For enrollment before June 1, 2026, tuition payments are due by June 1, 2026. For enrollment after June 1, 2026, tuition and registration fee are due no later than 1 week from enrollment.*
T-SHIRT SIZE (Each participant will receive a short-sleeve T-shirt, included in the Registration Fee. Not applicable for Storytime Ballet or Acting Improv)*

Child SmallChild MediumChild LargeChild Extra LargeAdult SmallAdult MediumAdult LargeAdult Extra LargeNO SHIRT (Enrolled in Ballet or Acting Improv only)
PROGRAM DETAILS HERE (Dates, Times, Descriptions)
SELECT UPCOMING PROGRAM(S) - Age based on 2025-2026 school year:*

25th ANNUAL PUTNAM COUNTY SPELLING BEE ~ ADAPTATION (9 yrs - 15 yrs) *July 13 - 24 (10:30am - 3:30pm) ($680) [*See website for exact details for Preliminary Day, Rehearsals, & Performance Info]CINDERELLA ~ ADAPTATION (1st - 5th Graders) August 17 - 21 (12:30pm - 3:30pm) ($305)FROZEN WEEK (4-7 yr Olds) August 17 - 21(9:00am - 11:30am) ($279)ACTING IMPROV (3rd - 6th Graders) Wednesdays 5/13-6/3 (5:00pm - 6:00pm) ($85)STORYTIME BALLET (3 1/2 - 5 yr olds) Wednesdays 5/13-6/3 (4:00pm - 5:00pm) ($85) [Mini in-studio performance on 6/3 for family at 4:45pm]
What size shirt/top does your student wear? blanks*
What size pants/bottoms does your student wear?blank*
(This information may be used to assist in costume selection, when applicable.)
Questions? Call (646) 221-3150
How do you prefer to pay?*

Cash (text Jessica at 646-221-3150 to arrange)Zelle (use email: performingarts5678@gmail.com. PA5678 is not responsible for Zelle errors.)Check: Payable to Performing Arts 5678. Mail to: 337 Diamond Hill Rd., Berkeley Heights, NJ 07922)
CANCELATION POLICY: 30 DAYS OR MORE NOTICE: Full tuition refund; 14 DAYS OR MORE: 50% tuition refund. 7 DAYS OR MORE: 25% tuition refund. (Registration Fees are not refundable.)*

I understand.
PLEASE NOTE: As the season progresses, this form will be updated, removing programs that are no longer available.
MEDICAL WAIVER & COVID INFORMATION:

COVID INFORMATION: Performing Arts 5678 follows the rules and guidelines set forth by New Jersey. As New Jersey adjusts rules, regulations, and guidelines, Performing Arts 5678 will adjust accordingly.

Currently, masks are not required. This is subject to change with NJ's rules.

MEDICAL WAIVER: I, the legal guardian of the student(s), have registered at Performing Arts 5678, agree to the following conditions: I recognize that participation in programs may occassionaly lead to injury. I authorize Performing Arts 5678 to contact the persons named as guardians and to authorize a physician to render treatment to my child as deemed necessary. I assume full financial responsibility for medical care for the participant while he/she is enrolled in Performing Arts 5678.

I, for myself and behalf of my student participant, also release waive and discharge Performing Arts 5678, all of its affiliates and related entities, and its officers, employees and representatives and their estates and/or heirs, from any and all claims which we may have for damages to property, personal injuries, medical situations or death as a result of participating in the programs sponsored by Performing Arts 5678. This releases and waives all claims which have happened and/or may happen as a result of participating in programming associated with Performing Arts 5678.

Health History

	Explain.
Please list any medical information the instructors should have about your child.

May over-the-counter medications be given to your child while in class? *

	No	Yes
Topical Antihistamines ("itchy cream") (ie: mosquito bite)
Headache Medication such as Tylenol or Ibuprofen

Have you read the above information and agree with all its terms and conditions?*

I agree
Name of Parent/Guardian that agrees and adhere to medical waiver*

First NameLast Name
Signature*

Clear
PHOTO & VIDEO RELEASE I, the legal guardian of the student(s) I have registered at Performing Arts 5678, agree to the following conditions: I grant permission for photographs and/or video to be taken during class, rehearsals, and/or performance(s). Photos and/or Videos may be used for advertising and/or social media. I understand that if I do not wish to have my child's picture taken, I will email: performingarts5678@gmail.com

BODILY INJURY RELEASE Student and his/her heirs, distribbutes, guardians, legal representatives, and assigns HEREBY WAIVE ANY AND ALL RIGHTS, LIABILITY, DAMAGES AND/OR CLAIMS AGAINST THE RELEASED PARTIES FOR BODILY INJURY OR PROPERTY DAMAGE WHICH MAY OCCUR DURING CLASS, REHEARSAL, AND/OR PERFORMANCE, AND HEREBY RELEASE AND FOREVER DISCHARGE THE RELEASED PARTIES, AND EACH OF THE FROM ALL CLAIMS ACTIONS, DEMANDS, RIGHTS, CAUSES OF ACTION AND LIABILITIES, EITHER BY LAW OR IN EQUITY, based on bodily injury or property damage to Student or any third party as a consequence of Student's participation in class, rehearsals, or performances, or as a result of negligence (orginary or gross negligence) by PERFORMING ARTS 5678. Student hereby agrees that it will never bring any legal action against PERFORMING ARTS 5678.
REFUND POLICY: In the event that you must cancel your student's registration, please see below.

30 DAYS OR MORE NOTICE: Full tuition refund

15 - 29 DAYS NOTICE: 50% tuition refund

7 - 14 DAYS NOTICE: 25% tuition refund

Less than 7 days NOTICE: No refund

Refunds must be requested in writing, via email (performingarts5678@gmail.com). Refunds will be made in the form of a check. If you would like to cancel and receive a refund prior to sessions beginning, you must request via email a minimum and tuition refunds will be given based on the above tiered system. Registration fees are non-refundable. Email: performingarts5678@gmail.com
Clicking the box below confirms that you have read the Photo & Video Release, Bodily Injury Release, and Refund Policy that you understand it, and that you agree to be bound by it.*

I agree
Name of Parent/Guardian that agrees and adhere to Photo & Video Release, Bodily Injury Release, and Refund Policy*

First NameLast Name
Signature*

Clear
Is there anything you would like us to know about your child?
How did you hear about us?*

Returning StudentFacebookInstagramWord of MouthFriend Referral (please type name below under "other" so we can thank them!)Other
Should be Empty:

Performing Arts 5678 SUMMER 2026 Registration Form