Next Star Registration
Use this form to sign up for the various classes offered.
PAY FOR CLASSES ON OUR WEBSITE:
using our secure PAYPAL portal
Questions? Call 804-663-8383
Select Class(es) for 2020
Etiquette Workshop - FREE (Ages 6-13; Jan 18, 2020)
Saturday Arts School-$80/month (Ages; 5 -14; Spring Semester Jan 25- April 25, 2020)
Public Speaking mini session-$50 (6th to 12th grade; Saturdays May 9-30, 2020)
Summer Camp- $125 first child, $100 additional (Ages 6 to 12; July 13-17, 2020)
Full Name of Child
Date of Birth
Medical Conditions(Allergies, etc.)
Other Conditions(Emotional, etc.)
T-Shirt size (Note: Returning students who have previously purchased T-shirts may skip to the next question. Cost:$15)
Name of Parent/Guardian
Emergency Contact Name
Emergency Contact Phone
How did you hear about us?
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.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service