OFFICIAL Registration Form for the 2022-2023 New York Academy After-School Program at P.S. 79
This form is the OFFICIAL registration form for the 2022-2023 school year after-school program held by New York Academy in the P.S. 79Q building. This form is not an inquiry form and is meant to secure a spot for the registrant. Please only submit this form if you are certain about attending the program in Fall 2022. All inquiries can be made to or 718-225-0022.

Program Hours: 2:20PM - 5:45PM


课后班时间:2:20PM - 5:45PM
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Email *
Is your child a returning student to this program? *
Student's Full Name *
Grade (in Fall 2022) *
Class (example. K-108)
You can either skip this question or type in "N/A" and we will follow up with you once the class numbers become available.
Parent Title/Name *
Parent's Email Address *
Parent's Phone Number *
Emergency Contact *
Please select which option you will be registering for: *
Does your child have injuries, medical conditions, or learning/behavioral accommodations that we should be aware of (Please list, if any, or write NO if otherwise): *
您的孩子是否有任何需要我们老师特别注意的地方,其中包括受伤,过敏,或者在学校有参与「個別學習計劃」 之类的。如果有,请详细地列出来。如果没有,请直接写个NO。
Program Policies
1. We will prioritize registration to students who attend full time (Monday to Friday) each week.

2. There is a limit of 15 students per grade. You will be put on the waitlist and given your number in line if we surpass the limit. If the waitlist comes close to 15 students as well, we will have a second class for that grade. The maximum number of classes possible for each grade will be 2 (so 30 students altogether for each grade will be the absolute maximum).

3. There is a one-time, non-refundable $75 registration fee for each new student.

4. There will be NO afterschool on half-days and when the school is closed for holidays, breaks, and snow days.

5. We will not be providing snacks to students during the program, due to concerns with allergens. However, snack time will be part of the schedule, so students may bring their own snacks for that time.

6. Invoices will be sent out as reminders the week before each pay cycle. A 5% late fee will incur if payments are kept outstanding for more than 4 weeks.

7. Sibling discount: $150 off the tuition of each child if they register for the full year program; $15 off the recurring tuition of each child for the 4-weeks program. No discounts will be given to those paying the daily rate.

8. Refund Policy: We will refund in full for cancellation before the start of the program. For the full year program, 75% will be refunded if you cancel within one month, 50% of the remaining tuition will be refunded if you cancel after one month.

9. We accept cash, checks, and money orders. Please make checks payable to New York Academy, include your child's name on the memo line, and bring it to our staff during pick-up. Cash must be sealed in an envelope. Zelle payments can be made to
   我们接受现金,支票,与汇票。支票请写给New York Academy并注明您孩子的名字然后在课后班接送时交给我们的工作人员或老师。现金必须封装在信封里。若用Zelle支付,请支付给

10. We reserve the right to remove students from class if they are being disruptive and withdraw students from the program if unacceptable behavior persists.
Terms of Agreement
As the parent or legal guardian of the above student, I hereby give permission for my child to participate in the programs of New York Academy and agree to comply with all program policies written above and other program regulations stated to me. In case of any emergency situation, if any of the student’s contact cannot be reached, I give full permission to New York Academy to obtain medical attention in necessity, for which I’ll be financially responsible. I hereby release New York Academy and all staff members of the institute from any responsibilities for bodily injury, property damage or theft of personal property that may occur while involved in the program on or off the site. By signing below, I hereby agree with the terms above, comply with New York Academy’s policies and assume financial responsibility for payment of classes taken by my child.

作为以上学生的家长或法定监护人,我允许我的孩子参加New York Academy的课程并同意遵守课程的规则与条例。如果在有任何紧急情况下无法联系到学生的家长和其他联系人,我完全允许New York Academy在必要时获得医疗照顾,我将对此负有经济责任。我释放New York Academy以及他们所有的工作人员从任何人身伤害,财产损害,或者个人的财产被盗的责任。通过以下签名,我在此同意上述
条款,遵守New York Academy的条例,并承担支付我孩子所上课程的经济责任。
Signature *
By signing my name below, I hereby acknowledge and will abide by the program policies and the terms of agreement. 通过在下面签署我的名字,我在此承认并将遵守以上的协议条款。
Date *
A copy of your responses will be emailed to the address you provided.
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