Registration Form - Kids CREATE School Break Movement + Art Program 2026

Registration + Permission Form

Participation in Kids CREATE - Dance For All
CREATE COUNCIL ON THE ARTS in partnership w/ Greene County Youth Bureau

KIDS CREATE
School Break Movement + Art Program

FREE WORKSHOPS DURING SPRING BREAK

APRIL 6th - 9th

DAILY: 9:30 A.M. TO 2:00 P.M.

CATSKILL ELEMENTARY SCHOOL "CAFETORIUM"
770 Embought Rd, Catskill, NY 12414

REGISTER FOR ONE OR MULTIPLE DAYS - FREE BUT PRE REGISTRATION IS REQUIRED

SNACKS PROVIDED STUDENTS BRING THEIR OWN LUNCH

MORE INFO:

FULL schedule, workshop descriptions + teaching artists

For questions, email: info@createcouncil.org
REGISTRATION INFO:
MON 4/6 (Grades K-2 / ages 4-7) 9:30am-2pm - CAPOEIRA PLAY + MUSIC w/ TaganTUE 4/7 (Grades K-2 / ages 4-7) 9:30am-2pm - CREATIVE MOVEMENT + ART w/ Jude + CorynWED 4/8 (Grades 3-6 / ages 8-11) 9:30am-2pm - CREATIVE MOVEMENT + ART w/ Jude + CorynTHU 4/9 (Grades 3-6 /ages 8-11) 9:30am-2pm - CAPOEIRA PLAY + MUSIC w/ Tagan
STUDENT INFO:
County of Residence*
Please let us know your County of Residence*
Student's Name:*

First NameLast Name
Does your child have a nickname they wish to use?
School Grade*
Age*
Student's Date of Birth*

MonthDayYear
Date
- Has your child had any dance/movement experience? Previous experience isn't necessary but please share if they have experience (can include dance, yoga, martial arts etc).*
- Please list any food allergies.*
  Families send their student with a daily lunch and CREATE provides two snacks.
- GUARDIAN / PARENT INFO:
- Guardian / Parent's Name:*
  
  First NameLast Name
- Email*
  example@example.com
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- EMERGENCY CONTACT INFO:
- Emergency Contact:*
  
  First NameLast Name
- Relationship to Student:*
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- PERMISSION
- YESNO
- YESNO
- YESNO
- By signing this form, I declare that I am the legal parent/guardian of the Student (minor child) listed above and authorized to grant such permission. Please sign below.
- Signature*
  
  Powered by Jotform SignClear
- ADDITIONAL INFO
- InstagramFacebookCREATE newsletterYour SchoolWord of MouthOther
- This will be the first timeDance for All (1 day)Dance for All (2 days)2nd Sunday Art ClubOutside the Lines - youth art showOther
- Anything else you’d like to share with us?
- Should be Empty:

Registration + Permission Form

REGISTRATION INFO:

STUDENT INFO:

GUARDIAN / PARENT INFO:

EMERGENCY CONTACT INFO:

PERMISSION

ADDITIONAL INFO