RS Summer 2024 Class Registration
We look forward to seeing you this summer!
The catalog, including detailed course brochures, is available on our website at https://renaissanceschool.org/community/summer/. 
For questions, please contact Registrar Lady Keller at lkeller@renaissanceschool.org or 434-984-1952.
Email *
Student Name *
Course(s) Registering For *
Required
Student Rising Grade *
Student Current School *
Student Rising School *
Student Email *
Parent Name *
Parent Email *
Parent Best Daytime Phone Number(s) *
Parent Mailing Address *
Parent 2 Name
Parent 2 Daytime Phone Number(s)
Emergency Contact if a Parent is not Reachable *
Emergency Contact Best Daytime Phone Number(s)
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If your child is highly allergic to anything and/or requires an epipen on their person, please explain:
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Medical Release

I/We, the parent(s)/guardian(s) of the above noted student do hereby constitute and appoint Renaissance School, acting by and through its authorized agents, attorney in fact for us in our name, place, and stead to exercise, do, or perform any act, right, power, duty or obligation whatsoever we have as the parent(s)/guardian(s) of the above named student relating to any necessary medical attention or treatment determined by a medical doctor to be necessary to be administered to our child on an emergency basis, to protect the well-being of our child, including, but not by way of limitation, the power, authority and right to authorize any and all surgical procedures and hospitalization that may in the discretion of Renaissance School, when so advised by a medical doctor, be determined to be necessary as emergency care and/or treatment. In witness whereof, I/we, the parent(s)/guardian(s) of the above named student have executed this limited power of attorney. -Parents write YES and print full name below to opt-in to waiver-

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A picture is worth a thousand words! Please help us tell the story of summer classes at RS by giving permission to include photos of your child in our newsletter, website, or social media. We do not use last names.

Website and Media Appearance Permission 2024-25
The Renaissance School website, press releases and print advertising strive to feature cross-curricular projects, current information and activities within our school. We require parental consent to put the student's work or image on the website, or in print. If you have any questions or concerns, feel free to contact the school. For Renaissance School Summer Classes 2024, I hereby give consent for my child to appear on the Renaissance School website,  and in print in a group or individual photo, or voice-over (including, but not limited to radio and television advertising and interviews).

Social Media Permission

The Renaissance School uses social media platforms (Facebook, Instagram, etc.) to promote the school. I consent for my child to appear in the School's social media posts. Parents write YES and sign with printed name below to opt-in, or only write NO to opt-out of waiver.

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Payment Method *
Is there anything else we should know? 
A copy of your responses will be emailed to .
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