Spring 2019 Registration
Classes begin January 19, 2019
Please note: A $15 Registration fee is required to reserve a spot for your child. Pay online using our secure paypal system.
Email address *
Full Name of Child *
Your answer
Student Status *
Age *
Date of Birth *
MM
/
DD
/
YYYY
Grade *
School
Your answer
Medical Conditions(Allergies, etc.) *
Your answer
Other Conditions(Emotional, etc.) *
Your answer
T-Shirt size (Note: Returning students who have previously purchased T-shirts may skip to the next question)
Name of Parent/Guardian *
Your answer
Phone *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
How did you hear about us? *
Your answer
Comments
Your answer
Consent
By clicking SUBMIT I agree and give my consent to the following:
The next star arts program (Next Star) staff takes all necessary precautions to ensure the safety of the students in their care. I agree to hold harmless Next Star or its partners, their agents, officers and/or employees from all claims, damages, injuries, or other liabilities of any kind whatsoever that could be brought now or in the future by me arising from any action or inaction.

I understand that certain reasonable risks may exist in allowing my child to participate in the program.
I agree to be responsible for all medical bills, costs, and expenses (including ambulance services) incurred in providing necessary care to my child, and/or I authorize the direct billing of my health insurance carrier. In cases of emergency, Next Star shall act merely as my agent and neither next star nor the staff shall incur any liability for the good faith exercise.

I understand that all tuition payments are non-refundable.

I understand that my child may appear in photographs and videos taken in the normal course of a class and during productions. I hereby authorize Next Star and to use such images and video for promotional purposes only.

A copy of your responses will be emailed to the address you provided.
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