Afterschool Program Registration & Policy Agreement

Afterschool Program Registration & Policy Agreement

Please complete, sign, and submit this form.
Student Information
Student Name*

First NameLast Name
School*
Grade*
Parent/Guardian Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Known Allergies
Do you allow the uploading, recording, or distribution of your child’s photo/video in any medium (including the internet) for advertisement and educational purposes?*

Yes, if faces are hiddenYesNo
Camps

Camp program is $300 for one week
Camp type
March Break / Rcm Camp / Summer Camp
Week #
Afterschool Program
Please select one:

Full-Time Program($500)Part-Time Program($350)
Program Policies
1. Withdrawal Policy
• 1-month notice is required to quit the program.
• A non-refundable half-month fee is due at registration and will be applied to the first month’s payment.
2. Behavior Policy
• Students may be asked to leave due to behaviour issues.
3. PD Days & Storm Days
• The program will run on PD and storm/snow days for $35/day.
• Storm day programs may be cancelled for staff safety; families will be notified.
4. Safety & Incidents
• While we prioritize safety, incidents may occur. Families will be notified immediately if anything happens.
Payment Method*

CashChequeE-Transfer (Email: smas202532@gmail.com)
Seraphina’s Music & Art School Contact Information
- Phone: 902-817-7007
- Email: smas202532@gmail.com
Liability Waiver
I, Parent Name* , as the parent/guardian of Student Name* acknowledge that participation in our studio program involves certain risks. I release Seraphina’s Music and Art and its staff from any liability related to injuries or incidents that may occur.
Parent/Guardian 1 Signature*

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Date:*

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Date
Agreement and Signature

By signing below, I confirm that the above information is accurate and that I agree to adhere to the studio's policies and guidelines.
Signature*

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Date*

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Afterschool Program Registration & Policy Agreement

Student Information

Camps

Afterschool Program

Program Policies

Seraphina’s Music & Art School Contact Information

Liability Waiver

Agreement and Signature