2023 Fun Fridays!- Reservation Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in our Enrichment Program! We look forward to providing exciting and fun, hands-on learning experiences! At this time, we are opening reservations for families wanting to secure a spot for our Fun Friday sessions for Homeschooled students.

PLEASE NOTE: Because space is limited, the submission of this form does not guarantee attendance. We accept members on a first-come, first-serve basis, however, we will prioritize based on the numerical order of the submitted responses.

Parent's (First & Last) Name *

Email *

Contact Number *

Student (First & Last) Name *

Student Age *

5 years old

6 years old

7 years old

Student Date of Birth *

YYYY

Allergies? Any special notes to consider? PLEASE EXPLAIN

If Applicable- SIBLING INFORMATION: Student (First & Last) Name

If Applicable- SIBLING INFORMATION: Student Age

5 years old

6 years old

7 years old

Clear selection

If Applicable- SIBLING INFORMATION: Student Date of Birth

YYYY

If Applicable- SIBLING INFORMATION: Allergies? Any special notes to consider? PLEASE EXPLAIN

EMERGENCY CONTACT: First/Last Name, Relationship to Child(ren), and Contact Number *

AUTHORIZED PICKUP (Other than Parent(s) Please include First/Last Name, Contact Number, and Relationship to student *

MEDIA RELEASE *

I give permission for Jada Robinson/Bright Minds STEAM Studio to use photographs of our child on the Bright Minds website and/or any fliers, brochures, or any other publication relative to Bright Minds STEAM Studio, as well as various other crafts. We realize that our child's name will not be used in such publications.

I DO NOT give permission for Jada Robinson/Bright Minds STEAM Studio to use photographs of our child on the Bright Minds website and/or any fliers, brochures, or any other publication relative to Bright Minds STEAM Studio.

SICKNESS POLICY- Bright Minds reserves the right to temporarily deny any child admittance to the school for reasons of obvious illness, or to request early departure should symptoms become apparent during the course of the day. This is to ensure the continued good health of everyone at the center. We ask for parents to assist by keeping sick children at home. [Please select to acknowledge] *

ILLNESS- I acknowledge my child will have to stay home for the following illnesses: Fever (children must be fever free, without medicine for 24hrs before returning), rash that requires an evaluation from the doctor, pink eye, thick yellow/green mucus, diarrhea, vomiting (for any reason), and a persistent hacking cough.

RUNNY NOSE- I acknowledge if my child is exhibiting symptoms correlating to the common cold (and in some cases seasonal allergies) my child may have to stay home to assist with limiting the spread of germs. This includes uncontrolled nasal discharge, and persistent sneezing/coughing etc

Required

TUITION/ATTENDANCE *

I acknowledge the program fee of $150 per child is due the 1st of each month. (Paypal invoice)

Absences & Makeup Policy- Because we are a tuition based program, we do not refund or give credit for classes missed during the semester.

I understand the structure of the program runs from month to month. Although I am not obligated for my child to remain enrolled the entire semester, I understand as a courtesy I must provide a 2-week written notice to withdraw my child.

Required

SESSION POLICY AND PROCEDURES: Please check to acknowledge the following: *

I understand space is limited and for safety precautions, only 5 spots are allotted. Submission of the form does not guarantee admission. If my reservation is submitted within the allowed maximum, the paid monthly program fee will solidify my child's admission to attend.

This is a drop-off enrichment class. Parents are free during this time!

Classes begin at 9:30am. Starting together is important for the cohesion of the session. Prompt drop-off and pickup (1:30pm) is appreciated.

Age-appropriate toys and materials will be available in the learning stations. For safety and hygienic reasons we ask that children refrain from bringing their own toys to the studio.

Safe and respectful behaviors are always expected in and around the classes . If there is an action or behavior that seems overly disrupting, distracting, or dangerous, the action or behavior will be communicated to the parent/guardian for a resolution by the next class. Our teachers will always respectfully redirect these behaviors with positive reinforcement.

Mid-morning snacks are provided. I will provide my child/ren with a water bottle, and nutritional lunch.

I understand an occasional Friday may include an offsite field trip, (included in the monthly cost) with the option for parents/siblings to attend as paid guests.

Medications will not be administered by studio staff.

I understand that no-contact temperature checks will be provided, along with the opportunity for hand washing/hand sanitizer breaks.

*Please Note-We are not trained or staffed to serve children who need specialized attention because of serious learning or behavioral challenges.*

Required

LIABILITY WAIVER - By typing my full name below, I hereby hold harmless, waive and release Bright Minds STEAM Studio, from liability as a result of personal injury or proper damage while the above child/children is/are in their care at the Studio. I understand that the enrichment classes are provided for a fee, which includes supplies. I have read, understand, and agree to adhere to the policies listed above. *

Any additional questions, comments, or concerns?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms