Student Registration NEW

Student Registration
All Student Registrations must be completed by a current member of Amber Academy. If you have not yet completed a Membership Application please click here to receive your Membership Number.
Membership Number*
*Please refer to your "Membership Confirmation" email for your Membership Number.
Privacy Statement: Personal information collected in this section will only be made available to class instructors and Board Members and will only be used for matters associated with Amber Academy managment. All information will be treated in confidence and will not be disclosed to any other party without the Member's consent.
Student Name:*

First NameLast Name
Date Of Birth:*

MonthDayYear
Student Email:
Class information will be sent to the Primary Email address provided in the Membership Application. If information should also be sent to the student please provide their email address.

Please select all classes that the student would like to join. There are no additional fees to join multiple classes.

*If you will be registering more than one student you will need click the "Register another Student" button on the "Thank You" page.
Monday Classes
Wednesday Classes
Friday Classes
Multi-Day Classes
Media Consent
I authorize Amber Academy Youth Fine Arts Society to use photos and/or video of myself and/or my child for promotional purposes in any type of media or publicity, including social media and website. I understand that students without said consent may be restricted from participating in some events where photos and/or video may be taken:
Yes No*
Other artistic experiences (students and/or family members, please specify):

0/100

The following class(es) are full at this time:

Art I (Grades K-2)

Theatre I - Junior Acting (Grades K-2)

If you wish to register your child for one of these classes, please complete your child's registration information and we will add them to our waitlist. You will be contacted when a space becomes available.

Emergency / Medical Information
Are there any allergies, medical conditions, special needs or behavioral concerns that could affect your child's ability to participate in activities at Amber Academy that the instructors should know about?

0/300
Family Physician:
BC Services Card No:
Please provide information for at least one (1) emergency contact and for all persons that may be picking up your child from time to time. Students under 10 years of age must be picked up by an idividual listed below unless our staff have been notified otherwise in writing.

*Email info should only be provided for contacts that need to be included on correspondence related to your child:
Primary Contact Name:*

First NameLast Name
Primary Contact Phone Number:*
Primary Contact Email:*
Contact 2:

First NameLast Name
Phone Number:
Email:
Contact 3:

First NameLast Name
Phone Number:
Email:
Contact 4:

First NameLast Name
Phone Number:
Email:
Waiver and Release
I (we) hereby give permission for my child/ward to participate in any activity sponsored/supported by Amber Academy Youth Fine Arts Society (herein called the Society) under the Society's program. I acknowledge and agree that in consideration of my child/ward being permitted to participate in the activities of Amber Academy Youth Fine Arts Society I (we):

1. do hereby release the Society, its Members, Officers, Directors, volunteers and independent contractors from all liability, claims, causes of action of any kind whatsoever in respect of all personal injuries, loss of life or property losses which our child/ward may suffer arising out of the activities of the Society; and

2. do hereby acknowledge and agree that I (we):
a. have carefully read this Waiver and Release, that I (we) fully understand same, and that I am (we are) freely and voluntarily executing same.
b. understand clearly that by signing this Release I (we) will be forever prevented from suing or otherwise claiming against the Association, its Members, Officers, Directors, volunteers or independent contractors with respect to any matter arising from these activities.

Parent/Guardian Signature*

*When only one parent signs to indicate consent, he/she does so in good faith and is presumed to be acting with the consent of the other legal parent/guardian.

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Student Registration

Please select all classes that the student would like to join. There are no additional fees to join multiple classes.

Emergency / Medical Information