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Polaris Circus Arts Class Registration
Thank you for you interest in joining our Winter Session. Please note that classes will run 1/18-3/25/2021. Please contact Polly Solomon at 914-310-2073 or
ps.aerial.arts@gmail.com
with any questions about the registration process.
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Email
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Your email
Student's Name:
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Your answer
Student's Date of Birth:
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MM
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YYYY
Name of Parent or Guardian (if student is under 18):
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Address:
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Your answer
Phone Number:
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Your answer
Alternate Phone Number:
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Emergency Contact Name:
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Your answer
Emergency Contact Phone Number:
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Your answer
Relation of Emergency Contact to Student
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Your answer
Do you have any medical restrictions, accessibility needs, or learning adaptations you would like us to be aware of? Answers to this question will be kept private and only used to help us better understand how to meet your needs.
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Which class(es) are you registering for?
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Circus Arts At Home Grades K-2 Tuesdays 4:00-4:55
Circus Arts At Home Grades K-2 Thursdays 4:00-4:55
Circus Arts At Home Grades 3-5 Mondays 4:00-4:55
Circus Arts At Home Grades 3-5 Wednesdays 3:00-3:55
Circus Arts for Tweens & Teens Mondays 3:00-3:55
Circus Arts for Tweens & Teens Wednesdays 4:00-4:55
Move & Stretch Tuesdays and Thursdays 5:00-5:55 Pack of 8 Classes
Move & Stretch Tuesdays and Thursdays 5:00-5:55 Drop In
Required
How would you like to receive your circus equipment?
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I will pick it up in Woodside, Queens (call to schedule).
I want my equipment delivered to my home in NYC or the surrounding areas on 1/9, 1/10, 1/16 or 1/17
Please mail me my equipment. I understand I will be charged a shipping fee.
I am only signing up for Move & Stretch and there is no equipment distributed for my class.
Did someone refer you to our program? Let us know who to thank!
Your answer
Media Release: I understand that Polly Solomon will document classes for grant recording, archival, educational, and/or promotional purposes, using photo, video, or audio recording and understand that this may include likenesses of me or my child.
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I Agree
Please click "Submit" to complete your registration. Once registered you will receive information on making your tuition payment, signing your participation waiver, and receiving your equipment (for classes with equipment). Please contact Polly Solomon at 914-310-2073 or
ps.aerial.arts@gmail.com
with any questions.
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