Summer 2024 Information & Consent Form

Student Information & Consent Form

Summer 2024
PLEASE READ:

This form gives us the specific information we need to serve your student best, and we will not use it or share it beyond the Wheelock Family Theatre.

This form gives us specific information we need to serve your student best. We will not use it or share it beyond Wheelock Family Threatre (WFT) staff. Please complete all sections and to read the "WFT Program Rules & Guidelines." These documents can be found within the form and also on our website.

We will keep this information confidential.
Student's Name*

First NameLast NameSuffix
Student's Date of Birth*

MonthDayYear
Date
Student's Grade*
The student's grade in fall of 2024
Student's Pronouns
Student's Preferred Name(s)

We LOVE, CELEBRATE, and INCLUDE learners of ALL KINDS!
Is there any information about your child's learning style or social and/or emotional development that will help them be most successful in class? Does your child benefit from an IEP or 504 at school?*
Write N/A if none.
Does your student require accessibility supports and/or accommodations? *
Write N/A if none.
Would you like a member of the WFT staff to contact you prior to the start of your student's first day of class to discuss accommodations?

YesNo
Please upload any IEPs, accommodation information, or support documents that might be useful for our staff.

Cancelof

General Medical History
If your student has any allergies (food, medication, environmental) list and explain them here:*
Write N/A if none.
List any medical conditions we should be aware of (asthma, seizures, headaches, etc.):*
Write N/A if none.
List any medications taken regularly we should be aware of:*
Write N/A if none.
Would you like a member of the WFT staff to contact you prior to the start of your student's first day of class to discuss the provided medical information?

YesNo

Primary Parent/Guardian's Information

Please provide the following information for the primary parent/guardian for the student during the summer program.
Name*

First NameLast Name
Pronouns
Relationship to the Student*
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Primary Phone Type*
Secondary Phone Number
Secondary Phone Type
Would you like to add a Secondary Parent/Guardian's Contact Information?

YesNo

Secondary Parent/Guardian's Information

Please provide the following information for the secondary parent/guardian for the student during the summer program.
Name*

First NameLast Name
Pronouns
Relationship to the Student*
Email Address*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Primary Phone Type*
Secondary Phone Number
Secondary Phone Type

Emergency Contacts

In addition to the name(s) you just provided as the Primary Parent/Guardian’s Information, you can list up to two additional emergency contacts (for a total of up to four contacts) for the student. Every student needs at least two contacts on file.
Emergency Contact 1
Name

First NameLast Name
Relationship to Student
Phone Number
Please enter a valid phone number.
Email
example@example.com

Emergency Contact 2
Name

First NameLast Name
Relationship to Student
Phone Number
Please enter a valid phone number.
Email
example@example.com

Pick-Up & Self-Release
Please list the first & last names of any individuals, not including the primary, secondary and emergency contacts, who are approved to pick-up your student.
I acknowledge my student is at least 13 years old and has permission to leave Wheelock Family Theatre on their own at the end of the day.*

YesNo
Students younger than 13, with (a) sibling(s) who is at least 13, may leave with their older sibling with written approval. Please email wfted@bu.edu with the names of the two students and the programs they're registered for.

Education Program Rules & Expectations
We developed the following guidelines to make sure that all our students have a great experience at WFT@BU We expect that our students will learn a lot, be safe, and have a great time at WFT@BU! Thanks for reviewing this information with your student and indicating your agreement by signing the consent form on the following page.

REGISTRATION CONFIRMATION/RECEIPT
Online registrants should receive automatic confirmation via email. For those who register with a paper form, a confirmation email will be sent within five business days. If you have any questions about registration please email a member of our education team at WFTEd@BU.edu.

REFUNDS & CANCELLATIONS
Your full payment will be refunded when a class is already full or canceled due to low enrollment. If the scheduled time, location, or content of a class is changed after payment has been received, you will be contacted and offered the options of continuing with the class or receiving a full refund. Otherwise requests for refunds for summer classes must be made six weeks before the start of the class. To request a refund, email WFTED@bu.edu. Refund requests made after this time will be offered the option to transfer registration to an upcoming program or credit to be used toward future programming before June 30, 2025.

RETURNED CHECKS
There will be a $30 fee for any check returned by the bank.

SCHOLARSHIPS
Full and partial scholarships are available and awarded on the basis of financial need. Click here to request tuition assistance.

ACCESS & INCLUSION
WFT@BU makes every possible effort to accommodate students with special needs and physical or cognitive disabilities. An Education Support Specialist can serve as a helpful liaison between these students and the class to help ensure a positive experience for all. Families are encouraged to provide WFT@BU with any necessary information during registration to help us assess such needs. Click here to learn more.

ENROLLMENT & CLASS AGES
All programs (except those designated as audition based) enroll on a first-come-first-served basis. Programs are limited in size and contingent upon adequate enrollment. Advertised age/ grade brackets are strictly upheld per class. Students who fall outside of a class’s age/grade bracket will be waitlisted and considered for enrollment only if circumstances allow. All summer programming refers to a student’s anticipated grade in the fall of that year.

CLASS GUESTS
We ask that parents not attend classes with their children. It is our experience that children do best if unaccompanied. All classes are participatory, and observation by non-participants can be inhibiting. Friends and family are invited to attend demonstrations and presentations on the final day of class.

LIABILITY
We expect that students will stay on the premises in designated, supervised areas. We accept responsibility for your child only when enrolled as a student during specified class times. WFT@BU is not liable for the well-being and safety of children who are around any of our facilities before a program begins or after a program ends.

CODE OF CONDUCT
We expect that students will behave appropriately and respectfully. If a student exhibits behavior that disrupts the class, including verbal abuse and vandalism, we’ll first speak with the student. If the behavior is repeated, we’ll contact you. And, if the behavior is repeated a third time, we’ll need to dismiss the student from the program without a refund. We expect that students will be considerate of others, physically and verbally, at all times and will refrain from running and rough-housing.

ATTENDANCE
It is expected that students enrolled in our programs take their commitment seriously. Attendance is expected for every class meeting. We ask that parents call WFT at 617-353-2994 if a child is unable to attend a class or rehearsal and that the child be absent only in the case of emergency or illness.

LATE PICK-UP
Please pick up your child on time. Parents will be assessed a $10 fee per half-hour if more than 15 minutes late.

APPROPRIATE DRESS
Our classes are physical and involve movement, so students should wear comfortable clothes and appropriate footgear. Bare feet, flip-flops, Crocs, etc., are unsafe and not appropriate.

NUT-FREE PROGRAM
What you send for snacks is limited only by your imagination—and our nut-free policy. No tree nuts or peanuts, please!

PHOTOGRAPHY AND VIDEOGRAPHY
Wheelock Family Theatre and contracted photographers reserve the right to use photos and videos taken in class/camp for promotional and archival purposes. The taking of photographs, videotaping, and the use of recording devices is not permitted during performances of copyrighted material.

INCLEMENT WEATHER
All registered families will be emailed if class is cancelled due to weather. You can also email wfted@bu.edu for updates on classes.

MAKE-UP POLICY
WFT@BU does not guarantee that classes cancelled due to circumstances beyond our control (i.e. weather, power outage) will be made up; no refunds will be issued. We do not offer make-up classes due to a child’s inability to attend.

BEFORECARE & AFTERCARE
Before care (8am to 9am) and after care (3:30pm to 5:00pm) will be available for all of our summer programs for an additional fee. Families will be contacted the week prior to the start of the program to register for either/both options. You’ll have the option to purchase by day or for the entire week.

DROP OFF AND PICK UP
For summer programs, drop off and pick up occur along Pilgrim Road behind the theatre. Please refer to additional instructions in welcome emails sent approximately 2-weeks prior to the start of each program.

Release Agreement
I hereby authorize {nameOf} (Student) to participate in the Wheelock Family Theatre at Boston University (WFT@BU) Education Program.

I {name} have read the WFT@BU Education Program Rules & Expectations and I agree with them. I understand that my Student may be dismissed permanently from class if they do not follow the rules set by WFT@BU and/or if a disciplinary problem arises. I understand that my Student will be under the supervision of WFT@BU staff and appointees. I understand that despite the responsible supervision that WFT@BU will make in this connection, WFT@BU cannot guarantee against the possibility of accident involving my Student. I hereby waive any claim that might be made against WFT@BU, its employees, and its agents in connection with any injury my Student may incur, other than claim resulting from the gross negligence of WFT@BU, its employees, or its agents.
I further authorize that any photographs, films, or other recordings that WFT@BU may make or authorize to be made of these activities may be used by WFT@BU without compensation to my child or me.*

YesNo
Parent/Guardian Signature*

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Date
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Student Information & Consent Form

We LOVE, CELEBRATE, and INCLUDE learners of ALL KINDS!

General Medical History

Primary Parent/Guardian's Information

Secondary Parent/Guardian's Information

Emergency Contacts

Pick-Up & Self-Release

Education Program Rules & Expectations

Release Agreement