Create_ Sewing Studio Childrens Classes Registration Form

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					                                                                    Create! Sewing Studio
                                                             Childrens Classes Registration Form
                                                                    70 Seminole Rd., Acton, MA 01720
  Where You Learn to Sew with Friends                           

                                          PLEASE PRINT ALL INFORMATION
                                        New Student             Past Student

Student name
                                                                                     To register your child for a class,
Street address                                                                        please write a check for $149.
Town                                                  Zip                            payable to Create! Sewing Studio
                                                                                      and mail to: 70 Seminole Road,
School                                                                                      Acton, MA 01720.

Date of Birth
                                                                                     Students are registered once full
Phone                                                                                     payment is received.

Parent’s Names

Work Phone Mom                                                      Dad

Parent’s Email

Secondary Email

Mom Cell                                                            Dad Cell

Emergency Contact

Child’s Primary Care Physician                                             Phone

If your child has special challenges of any kind, allergies, medical or learning disability please let me know:

Permission is given to person(s)                                           to pick up my child from Create! Sewing Studio.

Contact phone number for person (other than parent) picking up child

Signature:                                                                 Today’s Date:

8 week Sessions:
1st choice day
2nd choice day
Summer Week Choice

                                                                                 Bal pd __         Conf Sent __      Immun __
                                                                           Create! Sewing Studio
                                                                   Sewing Class Waiver Form
                                                                        70 Seminole Rd., Acton, MA 01720
   Where You Learn to Sew with Friends                            

By signing below I acknowledge for myself and, if applicable, on behalf of my child, the following:

I agree to release and hold harmless Rebecca Szetela and Create! Sewing Studio from any and all claims or liability related to
any accident that may arise as a result of my and/or my child’s participation in this program. I understand that sewing includes
the use of machines, needles, scissors and other tools. These activities include risks that can cause or lead to injury. I grant
permission to operate machines and to use tools and equipment. I give permission for first aid and/or medical treatment to be
given if the need arises.
PHOTOGRAPHIC RELEASE: I grant to Create! Sewing Studio, its representatives and employees the right to take photo-
graphs of me and/or my child in connection with sewing classes. I authorize Create! Sewing Studio its assigns and transferees
to copyright, use and publish the same in print and/or electronically. I agree that Create! Sewing Studio may use such photo-
graphs of me/my child with or without my or my child’s name and for any lawful purpose, including for example such purposes
as publicity, illustration, advertising, and Web content. I have read and understand the above.
REFUNDS & WITHDRAWAL POLICY: You may withdraw from a program up to 7 (seven) business days prior to the start date
- an administration fee of $10 will be applied to all registrations. After that time, no refunds will be issued. All refunds must be
submitted in writing to Create! Sewing Studio requesting withdrawal and refund. It will take two to three weeks for the refund to
be processed. Refunds will not be made for classes missed due to inclement weather. Exception to policy: a written letter from
a licensed physician excusing participant from a program. Create! Sewing Studio reserves the right to suspend a participant in
a program due to inappropriate behavior. No refunds will be given for any participant who has been suspended from a pro-
gram. There are NO refunds or credits for student absences. There is a $25.00 fee for returned checks.
CLASS CANCELLATION POLICY: Classes are cancelled if Acton Boxborough Schools have closed or have early dismissal
due to weather. Notification via email will be attempted but not guaranteed if a class is cancelled due to poor weather condi-
tions. Efforts will be made to make-up weather cancelled classes, but are not guaranteed. Any class cancellations due to an
illness of the instructor will be made-up or refunded. I reserve the right to either offer a make up a class or issue a refund if a
class is cancelled due to my absence. Make ups are not guaranteed. Refunds will not be offered due to a participant’s inability
to partake in missed make-up sessions. Refunds or class make-ups are not guaranteed due to a participant’s illness or any
other reason and are offered at the discretion of the instructor. Make-up classes for private and semi-private students can be
scheduled with a minimum of one week’s notice.

_____________________________________________________                      __________________
Signature of Parent/Guardian or Class Participant over age 18              Date

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