Nueva York Kiddos' Registration Form
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Email *
Student's First Name / Last Name (If you are registering 2 siblings please specify student 1 and 2) *
Gender: *
Student 1 Date of Birth *
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Student 2 Date of Birth
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School / Grade / Class *
Student's Address *
Parent / guardian 1 Name and Last Name
*
Parent / guardian 1 phone number and email *
Parent / guardian 2 Name and Last Name
Parent / guardian 2  phone number and email
Language spoke at home *
Spanish Level (zero / beginner / intermediate / fluent): *
Required
How did you hear about us?
Please indicate what program you are registering for: *
Required
Please indicate the day(s) or dates you are registering for: *
Please indicate what schedule you are registering for:
In case of an emergency, whom should we contact? *
Full Name / phone number / email *
If none of your children’s emergency contacts can be reached, what do you want staff to do if your child is sick or injured? Do you authorize Nueva York Kiddos staff / volunteers to arrange for emergency medical care for your child as needed? *
Do you authorize Nueva York Kiddos to take your child on supervised outings and group projects outside of the classroom? *
Is there anything in particular we should know about your child (any allergies, health issues, food restrictions, etc.):
Please list some of your child interests, likes and dislikes: *
Is there any behavior issues we should know about?:
NUEVA YORK KIDDOS  Permission / Waiver RELEASE OF LIABILITY: This is a release of liability and waiver of certain legal rights. I, the undersigned parent or legal guardian of the child/children listed above (herein referred to as “Child”), provide consent for my Child to participate in the classes, workshops, activities and/or outings provided by Nueva York Kiddos. While Nueva York Kiddos staff and family volunteers will always aim to be as careful and aware of potentially dangerous situations, accidents can happen especially when children are in the park and interacting with natural and outdoor elements. I understand these risks and declare that my Child is physically healthy and claim that my Child is safely capable of participating in these classes, workshops, activities and outings. I will not be holding Nueva York Kiddos or any employees of Nueva York Kiddos liable if an accident occurs involving my child during Nueva York Kiddos class while on-site at 163 Bayard St, Brooklyn NY 11222 or off-site. Indicate acceptance by typing your full name name below: *
Student's Name *
Parent(s) and/or legal guardian(s) of child: *
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Print: *
PUBLICITY: On occasion, NUEVA YORK KIDDOS may take photographs or video recordings of children during activities. Such photographs or videos may be used to remember the activities and participants. In addition, such photographs and audio/visual recordings may be used in NUEVA YORK KIDDOS advertising materials to let others know about their program.I consent to the use of any such photograph or video recording of the child named above, to be used, distributed, or displayed in NUEVA YORK KIDDOS promotional material. Indicate acceptance by typing your full name name below: *
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YOU WILL RECEIVE AN EMAIL WITH DETAILED TUITION INFORMATION.
Below please select what payment method you will use to submit tuition.

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Required
FOR EVERY NUEVA YORK KIDDOS' CLASS PLEASE MAKE SURE YOUR KIDS WEAR (WEATHER APPROPRIATE) COMFORTABLE WORRY-FREE CLOTHES. ¡GRACIAS! We are looking forward to teaching Spanish and having lots of fun with your kid(s)! PLEASE FEEL FREE TO CONTACT US at  nuevayorkkiddos@gmail.com 
A copy of your responses will be emailed to the address you provided.
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