ARTS IN ACTION VAP, INC™ – FALL 2008 REGISTRATION FORM
Child’s First Name:_________________Last Name:___________________________Birth Date:___________
School Name:______________________Grade:____Teacher name & Room #____________Gender: M F
Address:____________________________________Apt.:_____City:_________State:____Zip:____________
Please enter 1st and 2nd Choice of Class Day: Monday _____Tuesday_____Wednesday_____
Thursday_____Thursday Portfolio Development ____Thursday 8th Grade Portfolio Prep______Friday______
Parent/Guardian:_______________________________Home Phone:______________Email:_______________
Cell phone: _________________________________ Work Phone:___________________________________
Parent/Guardian:______________________________Home Phone:_______________Email:_______________
Cell phone:___________________________________Work Phone:___________________________________
Emergency Contact (available from 3-6 PM):_____________________Relationship:__________Phone:______
The following adults are authorized to pick up my child:
Name:____________________________Relationship:___________________Phone (from 3-6):____________
Name:____________________________Relationship:___________________Phone (from 3-6):____________
You have the responsibility to inform AIAVAP if someone is not legally permitted to pick up your child or if someone other than those listed above are picking up your child. Let us know in advance in writing.
Medical Information:
Does your child have any allergies? Medications? Yes___________No_____________
If yes, please explain_________________________________________________________________________
Doctor’ s name:______________________________________________Phone:_________________________
Please describe any physical problems or limitations your child has: __________________________________________________________________________________________
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TUITION FEE- 1st choice day_____________
-sibling discount
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-
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REGISTRATION FEE
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+$25.00
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PAYMENT PLAN
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+
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PICK-UP FEE (PS 87 only)
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+
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MATERIALS FEE
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+35.00
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TOTAL DUE by Monday, September 1, 2008
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Total due is payable by personal check, cash or money order.
Make checks payable to Arts in Action VAP, Inc.
Send pages 1 and 2 signed to:
Arts in Action VAP, Inc.
C/o Schmidt
711 Amsterdam Avenue, #10G
New York, NY 10025
Arts in Action Visual Art Program (AIAVAP) Terms and Conditions
For participants in the Afterschool Program
FALL 2008
I understand and agree:
1. That this payment is for the Fall 2008 term and that I shall not be entitled to any deduction for my child’s absences or illnesses during the term; that in the event of my child’s withdrawal or suspension (see item #3 below) from the Program after classes have started, I shall not be entitled to any refund of unused tuition;
2. That the Program cannot issue refunds for afterschool classes not attended due to the scheduling of half or full day school closings. Make-up lessons can be scheduled by written appointment. Please refer to the AIAVAP calendar posted on our website at www.artsinactionvap.org. Please refer to AIA VAP’s class schedule if you not sure if there will be class.
3. That the Program requires my child to meet certain standards of behavior and that if my child fails to behave or demonstrates repeated unsatisfactory conduct, the Program has the right to dismiss my child from the Program;
4. That if my child is not picked up by 5:30 PM, I agree to pay a lateness fee according to program policy; and that my child may be taken to the local Police Precinct #24 at 151 W. 100 Street in the event no one is available to supervise my child after 6:00 PM.
5. That if my child is injured and requires medical attention and I cannot be reached for instructions, I do hereby give authority to AIAVAP to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible. I give permission for AIAVAP personnel to treat minor injuries on site.
6. That AIAVAP reserves the right to modify the classes, change instructors or site as necessary, or to cancel the class not meeting enrollment;
7. That during the afterschool class, my child may be photographed and/or videotaped by AIAVAP personnel or its authorized agents exclusively for internal and/or promotional use;
8. That my child’s artwork produced during the AIAVAP classes, may be photocopied or copied using other methods to be used in publications and/or fundraising for AIAVAP without remuneration.
9. That some classes may involve trips outside the building supervised by staff of the AIAVAP afterschool program. I give AIAVAP permission to take my child to go on any such trips organized as part of the Program, including (but not limited to) neighborhood parks, galleries, artist studios, museums and other schools;
10. That in consideration of allowing my child to participate in the AIAVAP afterschool program, I hereby release and forever discharge AIAVAP and Little Shop of Crafts and its officers, volunteers, employees, contractors and agents from any liability arising out of or based upon any bodily injury or property damage which may be sustained by my child while participating in such program.
11. That each parent/guardian must notify AIAVAP by phone (212) 864-4883, (917) 343-4242 or email artsinactionvap@aol.com when their child will not be attending class 24 hours in advance. AIAVAP will not be held responsible for children who are not in attendance in the classroom or at their pickup place.
12. That these terms of agreement #1-11 will be applicable for school year September 10, 2008 – June 25, 2009.
Parent/Guardian Signature:_________________________________________Date:______________________
Printed Name:_______________________________________________________________
ARTS IN ACTION VAP, INC. FALL Semester 2008
PLEASE KEEP THIS PAGE FOR REFERENCE
General Information:
Arts In Action Visual Art Program, Inc.™ (AIAVAP) is a non-profit 501c3 organization that provides a unique, sequentially-structured art education program using a visual language that all fine artists learn to communicate through. Since 1987, Angela Tripi-Weiss, Director of AIAVAP, has spearheaded non-profit art programs that empower children. Ms. Tripi-Weiss, three-time Blackboard Award winner, has been called "one of the best visual educators in Manhattan...a tour de force" and directed Arts in Action at P.S. 87 in Manhattan for 18 years.
FALL 2008 term: Mon., Sept. 8, 2008 – Friday, Feb. 6, 2009
Arts in Action Visual Art Program, Inc. is a not-for-profit corporation (Fed. ID 56-2322737)
Classes are held at Little Shop of Crafts, 94th and Amsterdam Avenue, northeast corner
Arts in Action VAP, Inc. main phone: (212) 864-4883 or 917-363-4242 or artsinactionvap@aol.com
On-site phone at Little Shop of Crafts (for emergencies only): (212) 531-2723
Fees for Sept. 8, 2008 – June 26, 2009 ($45 per regular afterschool class ; $60 per Thursday Portfolio Development class 5:30-7:30 pm for Ages 11 to 14; $80 per Thursday class for 8th grade applicants to Specialized High Schools – 10 sessions)
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MONDAYS –
4:00-5:30
Ages 5 to 8/9
18 CLASSES $810
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Ages 8 to 11/12
18 CLASSES $810
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WEDNESDAYS
4:00-5:30
Ages 5 to 8/9
18 CLASSES $810
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THURSDAYS –
3:45-5:15
Ages 9 to 11/12
18 CLASSES $810
5:30-7:30: Portfolio Development
Ages 11-14
18 CLASSES $1,080
Portfolio Prep: 8th Grade applicants to High Schools:
10 CLASSES $800
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FRIDAYS –
4:00-5:30
Ages 5 to 8/9
18 CLASSES $810
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School pick-up fee - PS 87 only
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MONDAYS
$90
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TUESDAYS
$90
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WEDNESDAYS $90
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THURSDAYS
$90
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FRIDAYS
$90
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Sibling discount (Sibling of a registered student will receive 5% off):
Please use separate forms for each child, and take the discount on the sibling’s form. Deduct $40 for regular Afterschool classes and $54 for Thursday Portfolio Development Class
OTHER FEES: Registration fee: $25 · Materials fee: $35 · Lateness fee: $30 (past 5:30 PM)
Payment plan – 2 equal payments, paid by post-dated checks only at registration. $20
Returned check fee: $25
Arts in Action VAP, Inc. reserves the right to cancel any classes due to under enrollment. Full refunds will be given and notice given before classes start on Sept. 8, 2008 if the class is cancelled.
Contribute to Arts in Action VAP Scholarship Fund! Help make afterschool accessible to all children who want to participate by making a donation to Arts in Action VAP. You can make your tax-deductible donation when you enroll your child at registration. Phone: (212) 864-4883 · fax: (212) 864-9166 · Email: artsinactionvap@aol.com · www.artsinactionvap.org
