Register for Creative Explorers (6-8 yrs)

Please fill in the required information below. ALL CLASSES ARE CURRENTLY FULL; HOWEVER PLEASE FEEL FREE TO CONTINUE THE REGISTRATION PROCESS & SELECT THE “WAIT-LIST” OPTION FOR YOUR PREFERRED CLASS(ES). Please do NOT pay the registration fee. Once you are notified that your child is enrolled in class you may pay at that time* . I am charged a fee from Paypal so if you pay now I will have to deduct the fee from any refunds. Thank you! (*If you have been notified your child is enrolled in my class, please follow these directions to pay your registration fee. - Once your form has been completed, please go to Make a Payment to complete the registration process. Submission of this form does not guarantee enrollment in the class. Once registration fee has been paid, the instructor will confirm that space is available in the class and that your child has been added to the class roster.) Registration fees are non-refundable as they reserve your child’s place in the class; however, if the class is full, your registration fee will be returned.

Student's name *
Student's name
Student's birthday *
Student's birthday
Mother's name *
Mother's name
Mother's cell phone *
Mother's cell phone
Father's name
Father's name
Father's cell phone
Father's cell phone
Home address
Home address
Emergency contact *
Emergency contact
Emergency contact phone *
Emergency contact phone
Would you like your child on the WAITLIST?
I agree to submit the $25.00 registration fee with this form (*unless you are on the wait-list, please wait until notified your child is now enrolled) and understand that my child will not be enrolled until this payment is received. I agree to pay the full semester tuition, due and payable in full on or before the first day of class or I must submit a Charter School PO/voucher on or before the first day of classes. I understand that I am liable to pay any amount not covered by my charter school. *
I hereby solely and expressly assume liability for all risks and waive any claim I might have against Cynthia Vaccaro or individuals acting in the capacity as agents of the organization (staff members, independent contractors, volunteers, etc.). I assume full legal liability for my child’s actions in class and release Cynthia Vaccaro and all agents acting on behalf of Cynthia Vaccaro from any claims made as a result of my actions. This release shall be effective and binding upon the parties, as well as their heirs, beneficiaries, assigns, successors and legal representatives. By checking the box, I acknowledge having read and understood this release. *
By entering your name below, you agree to the conditions set forth in this form.
Today's date *
Today's date