YUTH Intro Class Registration

Intro Class Registration

County Connections is funded directly by Harris County, CASE for Kids a division of Harris County Department of Education. All classes be held at The Artz located at 1824 Spring St. #124 Houston, Texas 77007.
The ARTZ and Yuth have teamed up with the City of Houston, CASE for Kids a division of Harris County Department of Education, to provide aerial classes to the youth ages 5 - 12.

The goal of the YUTH-The ARTZ project is to provide a unique and high-quality experience to youth grades K-12th through the avenue of aerial and circus arts. Our hope is children who would not normally be able to attend aerial and circus classes due to the financial burdens are able to come out and experience something amazing and creative which will expand their horizons. Students will have the opportunity to experience aerial & circus classes at The ARTZ.

$7 Intro to Aerial Class for Youth Ages 5-17

Tuesday Dates

June 17th, 3:30 pm - 4:15 pm

June 24th, 3:30 pm - 4:15 pm

July 8th, 3:30 pm - 4:15 pm

July 15th, 3:30 pm - 4:15 pm

July 22nd, 3:30 pm - 4:15 pm

July 29th, 3:30 pm - 4:15 pm

August 5th, 3:30 pm - 4:15 pm

August 12th, 3:30 pm - 4:15 pm

Wednesday Dates

June 11th, 4:45 pm - 5:30 pm

June 18th, 4:45 pm - 5:30 pm

June 25th, 4:45 pm - 5:30 pm

July 2nd, 4:45 pm - 5:30 pm

July 9th, 4:45 pm - 5:30 pm

July 16th, 4:45 pm - 5:30 pm

July 23rd, 4:45 pm - 5:30 pm

July 30th, 4:45 pm - 5:30 pm

August 6th, 4:45 pm - 5:30 pm

August 13th, 4:45 pm - 5:30 pm

Saturday Dates

June 14th, 11:30 am - 12:15 pm

June 21st, 11:30 am - 12:15 pm

June 28th, 11:30 am - 12:15 pm

July 12th, 11:30 am - 12:15 pm

July 19th, 11:30 am - 12:15 pm

July 26th, 11:30 am - 12:15 pm

August 9th, 11:30 am - 12:15 pm

August 16th, 11:30 am - 12:15 pm
STUDENT REGISTRATION FORM 2025

Please read carefully and print clearly. This registration form must be completed in it's entirety.
Full Name:*

Last Name
Date of Birth:*

MonthDayYear
Grade*
School*
Race*
TOTAL YEARLY INCOME BEFORE DEDUCTIONS OF ALL HOUSEHOLD MEMBERS (check one box below): Include wages, salary, welfare payments, child support, alimony, pensions, social security, worker's. Verification of income may be required.*

$0 - $21,590$21,591 - $29,101$29,102 - $36,612$36,613 - $44,123$44,124 - $51,634$59,146 - $66,656$66,657 - $74,167$74,168 - $81,678$81,679 - $89,189$89,190 - $96,700$96,701 - $104,211Other
Number of Children in Household *
Ethnicity*
Gender*
Allergies/Disabilities/Special Needs/Medications
Leave Blank if None
Participate in Recreational Activities?*

YesNo
Parent/Guardian Name *

First NameLast Name
Email Address*
Please list name and phone #
Mobile Phone *
Work Phone
Home Address:*

Address

Street Address Line 2

City Province

Postal Code
Emergency Email Contact (other than above)*

First NameLast Name
Mobile Phone *
I GIVE CONSENT FOR THE PROGRAM TO SECURE ANY AND ALL NECESSARY EMERGENCY MEDICAL CARE FOR MY CHILD(REN)*

YESNO
SECTION VI | PARENT/GUARDIAN CONSENT
For each section below, check the box(es) indicating whether or not you give your consent
I ACKNOWLEDGE that NO refunds will be given once fees are paid.*

I Agree
Receipt of written operational policies:*

I acknowledge receipt of the HCDE and Partners' operational policies, including those for discipline and guidance.
RECORDS:*

I acknowledge that my child(ren)'s immunization, vision, and hearings records are on file at the program campus/site.
Media/Video Release: I hereby give/do not give - my consent for HCDE and Partners to videotape/photograph/audiotape and/or allow the videotaping, photo taping of my children. It is my understanding that any photographs/interviews or portions thereof will be used for public view, including, but not limited to , promotional purposes, social media etc. without financial remuneration to myself or to my child(ren), and I understand that this releases HCDE and Partners from any future claims as well as from any liability arising from the use of said photo/video/interview. Texas Education Code 26.009(a)(2) requires that written consent be obtained from a child's parent before making a videotape of a child or recording a child's voice unless the video or recording is for the purpose of safety, a purpose related to a cucurricular or extracurricular activity, a purpose related to regular classroom instruction, or media coverage of the school.*

GiveDo not give
Evaluation Participation: I understand that my child(ren) or I may be asked to complete survey information regarding any CASE for kids-sponsored prom/classes for the purposes of program evaluation and program improvement. Questions may be related to any aspect of the after-school program, including Kids' Day events, and/or programming related to funding from the Houston Endowment, City of Houston, 21st CCLC/Texas ACE, etc. I understand that completing these surveys is voluntary and that my child or I may decline to complete the surveys. I give permission for my child(rens) academic and other personally identifiable information to HCDE and Partners, including grades, student conduct, attendance records, and standardized test scores for the reporting of required performance measures and for evaluation purposes. I understand that all data collected will be kept strictly confidential and destroyed when no longer needed. For high schools, I consent to HCDE and Partners communicating with my child(ren) via email.*

YESNO
RELEASE: I understand that HCDE and Partners assume no responsibility or liability for my child(ren)'s participation in the CASE for Kids program(s) or any activity related to the CASE for Kids program(s). On behalf of myself and on behalf of my child(ren), I do hereby and forever fully and unconditionally waive and release, and hold harmless HCDE and Partners, their agents, employees, officers, representatives, affiliates, successors, and assigns, jointly and severally, from any and all liability, claims, demands, and causes of action, known or unknown, in law and in equity, for physical or emotional injury, property damage, or death, including wrongful death, that my child(ren) may incur and/or suffer which are in any way connected with, arising out of, or resulting from my child(ren)'s participation in CASE for Kids program(s).
WAIVER INFORMATION

I/we realize that participation in aerial classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by The Artz & YUTH.

I/we agree to release and hold harmless The Artz & YUTH center including its teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold The Artz & YUTH liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by The Artz & YUTH.

I understand that The Artz & YUTH is an insured organization. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the Executive Director, Artistic Director, instructor or staff as soon as possible.

I do hereby grant permission to The Artz & YUTH to use the image of my/my child, Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my/my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters,advertising, videos, and digital images such as those on The Artz & YUTH website and Facebook page and other digital media for promotional usage only.

By signing this form, I understand that I am giving unrestricted permission for my/my child’s image to be used
in print, video, and digital media byThe Artz & YUTH for promotional usage only. I understand that I will be notified when and if images are used. I do understand that my/my child’s last name will not be used in conjunction with any video or digital images.

Parents of The Artz & YUTH students and their involvement are so important to the success of our program. The following codes of conduct for parents will ensure our students have a positive and successful experience in all programs: Please respect the expertise and decisions of the faculty and staff. Support your dancer at all times. Be attentive to people who are around you as you comment. Young dancers are very sensitive. Negative comments or those outside of your expertise can turn the most positive experience into a negative one. Instead, attempt to develop positive solutions and avoid gossip. If you have major concerns, see The Artz & YUTH Artistic Director or Executive Director, rather than discussing them with other parents. Be courteous and respectful to staff and students. Encourage your dancer to enjoy their training and to have fun. Think about the benefit your dancer receives from their dance experience including building strong, healthy bodies, moving to music which is a delightful experience, and making friends with other dancers. Parent Observation Policy Parents/Guest are welcomed to wait in the lobby or watch from the observation window outside the studio. Artz parents/guest are asked to please respect student’s learning environment by observing quietly without disturbing student through observation window, for this is a special time for both students and instructor. Guest waiting in the lobby are asked to keep noise volume to a minimum to ensure no distractions during class time. Parents/Guest are welcomed to relax and unwind while waiting for their student in the lobby, however we asked that parents/guest/kids reframe from opening the studio doors during class time to ensure students’ get their full allotted time with instructor. Parental Involvement The overall success of The Artz depends on parental involvement. It is important that parents volunteer to help where needed, especially with performances and fundraising. The Artz conducts many performances and several special events throughout the year. Although not mandatory, The Artz parent’s voluntary services would be greatly valued for performances and future events. The sign-up sheet will be posted in the lobby when voluntary services are needed.

The Artz dance instructors and staff will respect all students. In return, all students are expected to respect the Artz staff, their dance instructors and fellow students. The Artz will not tolerate inappropriate or disrespectful behavior or language. Discipline is an integral part of dance training. Punctuality and regular attendance is expected for classes, rehearsals, and performances. Students should arrive at least 10 minutes prior to class time in order to be ready to begin class at the scheduled time. Students are not allowed to arrive for class more than 30 minutes prior to the scheduled class start time. Since the first 15 minutes of class are crucial to properly warm the muscles, students arriving 15 minutes after class begins, without proper advance notification, will not be allowed to participate in class. Students must attend class on a regular basis. Sporadic attendance can cause a student to fall behind and may cause an injury. Only appropriate dance attire is to be worn in class and rehearsals. (See The Artz Dress Code.) Excessive talking is NOT allowed during class or rehearsal. Do not talk back to your teacher. Always accept criticism and corrections well. Try to make your teacher’s corrections immediately or ask questions if you need clarification. All students are asked to use the bathroom BEFORE class, rehearsal and/or performances begin. There will be no hanging on the barres at any time. No food or beverages, other than water, are allowed in the lobby, dressing room, or dance studio. Special circumstances may be approved by the director. Cell phones are to be turned off. Personal phone calls are not allowed during class unless there is an emergency situation as defined by a The Artz staff member. Students must follow instructions and directions at all times and are expected to maintain a positive, cooperative attitude. The Artz teachers will be treated with the utmost respect at all times and properly thanked after each class. Students are NOT allowed to bring friends to the dance studio. Disruptive or disrespectful behavior will result in the student being required to sit out or be dismissed from class resulting in parental notification. Repeated disruptive behavior and/or disrespect to instructors, staff, volunteers, or other students will not be tolerated and will result in disciplinary action.

All clients, students and parents must agree to these terms in order to proceed with our program.
I/We agree with the above*

YesNo
Signature*

Clear
Date*

MonthDayYear
Date
Date of class*

Tuesday, June 17thTuesday , June 24thTuesday, July 8thTuesday, July 15thTuesday, July 22ndTuesday, July 29thTuesday, August 5thTuesday, August 12thWednesday, June 11thWednesday, June 25thWednesday, July 2ndWednesday, July 9thWednesday, July 16thWednesday, July 23rdWednesday, July 30thWednesday, August 6thWednesday, August 13thSaturday, June 14thSaturday, June 21stSaturday, June 28thSaturday, July 5thSaturday, July 12thSaturday, July 19thSaturday, July 26thSaturday, August 2ndSaturday, August 9thSaturday, August 16th
My Products*
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Intro to Aerial$7.00
One intro to aerial class

Total $0.00

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Intro Class Registration

STUDENT REGISTRATION FORM 2025