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Giving Tuesday 2024
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Home
About Us
Mission, Values and Ideas
Who We Are
Annual Report 2023/24
Job Listings
Contact Us
Testimonials
Programs
Free Halloween Class
Free Community Ensembles
High School Conservatory
Financial Aid
Partnerships
PS 527
PS 6
Support BBK
Giving Tuesday 2024
Resources
Registration
Please complete the registration form below
to ensure your spot in our programs.
If registering more than one student, you must complete the form for each student.
A minimum of eight students must register per class for each course section to run.
You will receive an invoice from Stripe within 48 hours of completing the form with information about payment.
Your registration is not complete until both the form response and class tuition are received.
Payment must be received within 7 days of registration for your spot to be held in class. Payment plans are available on request.
*
Indicates required field
Parent/Guardian Name
*
First
Last
Billing Email
*
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Participant Information
Student Name
*
First
Last
[object Object]
Nickname or Preferred Name
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Gender Identity
*
Female
Male
Non-binary
Prefer not to answer
Pronouns
*
(i.e. she/her, he/they, they/them, ze/zir)
Which of the following best describes your student? Please select all that apply.
*
Asian/Pacific Islander
Black/African American
Hispanic/Latino
White/Caucasian
Multiracial
Native American/Alaska Native
I prefer not to answer
Other
We collect this data to inform the DEIAJ work we are committed to implementing at our organization. This information helps us know who we are serving and who we need to work harder to engage.
Preferred Language
*
Birthday
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Please input as MM/DD/YYYY. (i.e. 01/01/2022)
Grade in 2024-25 School Year
*
As of Fall 2022
How did you hear about Broadway Bound Kids?
*
Please share any information about your child's medical information, allergies, or needs that you would like us to know. In addition, if you want to share any information about your child's physician, please include it here.
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Guardian Name
*
Guardian Phone
*
Guardian Email (if different from billing)
*
Please list who is authorized to pick up your student:
Name
*
Phone Number
*
Name
*
Phone Number
*
Name
*
Name
*
Phone Number
*
Phone Number
*
Emergency Contacts
*
Please list parents/guardians who are authorized to pick up the child(ren). (list full name & relationship to child)
Emergency Contact Phone
*
Select Your Programs
Programs
*
Monday Jr. Drama Club (K-1) - $725
Monday Drama Club (2-5) - $725 - SOLD OUT; Register to be added to the waiting list or choose another class
Thursday Mix It Up Dance (K-1) - $725
Thursday Hip-Hop (2-5) - $725
Would you like to extend to 6pm for $100?
*
Yes
No
Liability Waiver
I hereby certify that I am the legal guardian of the child listed above. Furthermore, I have read this release of liability and assumption of risk and fully understand its terms. (Please note that you must agree to these terms in order for your child to participate in Broadway Bound Kids programs.)
Please Confirm
*
I agree
Please place your initials in each of
the boxes below.
Assumption of Risk and Waiver of Liability Related to Coronavirus/COVID-19
Attending in-person classes, programs, or
activities conducted by or in association with Broadway Bound Kids Inc. could increase
your risk and your child(ren)’s risk of contracting COVID-19. Broadway Bound Kids has
put in place preventative measures to reduce the spread of COVID-19 and seeks to
follow the guidance and recommendations of government health agencies such as the
Centers for Disease Control and Prevention and New York state and local government
authorities. However, Broadway Bound Kids cannot guarantee that you or your
child(ren) will not be exposed to or become infected with COVID-19 as a result of
participating in our activities. Please read this agreement carefully as your electronic
signature indicates that you have agreed to assume certain risks and to give up certain
rights.
ASSUMPTION OF RISK
By signing this agreement, I acknowledge that:
I have read the warning above concerning COVID-19 and understand there is a risk that I or my child(ren) may be exposed to or become infected with COVID-19 as a result of participating in Broadway Bound Kids’ classes and activities.
I understand such exposure or infection may result in personal injury, illness, permanent disability, or even death.
I understand that such exposure or infection could occur as a result of the actions, omissions, or negligence of myself, my children, or Broadway Bound Kids, its owners, directors, employees, agents, representatives, and volunteers.
I am voluntarily assuming this risk for myself and my child(ren) as part of participating in Broadway
Bound Kids’ classes and activities.
I value my child(ren) being able to participate in
Broadway Bound Kids’ classes and activities and am signing this agreement in
exchange for such participation.
Indicate your understanding and acceptance of the above statement by initialing below:
*
Agreement Not to Sue AND Waiver OF Liability
By signing this agreement, I also promise and agree not to sue or bring a lawsuit against Broadway Bound Kids, its owners, directors, employees, agents, representatives, or volunteers in connection with myself or my child(ren) being exposed to or infected with COVID-19 as a result of participating in BBK's programs.
I understand that by signing this agreement I am
waiving, releasing, and giving up any and all claims against, and agree to hold harmless,
Broadway Bound Kids, its owners, directors, employees, agents, representatives, or
volunteers in connection with myself or my child(ren) being exposed to or infected with
COVID-19 as a result of participating in any of Broadway Bound Kids’ classes or
activities.
Indicate your understanding and acceptance of the above statement by initialing below:
*
Photograph and Video Release
I give permission for any photographs, videos, or
sound recordings taken of my child(ren) during participation in any of Broadway Bound Kids’ classes or activities to be used by Broadway Bound Kids for marketing purposes. I consent to the use of any such photographs, videos, or sound recordings for marketing purposes on Broadway Bound Kids’ website and marketing materials including any promotional posters, flyers, brochures, printed and electronic ads, electronic media, etc. I understand that I will not receive compensation in any form for the use of my child(ren)’s likeness in photograph or video, and/or recorded voice.
I understand that
under no circumstance will Broadway Kids use my child(ren)’s name
in any marketing materials.
Please confirm your agreement to the Photo and Video Release statement
*
I agree
I agree with limitations
Please clarify limitations.
*
Other Matters
I agree that this Agreement will be governed by the laws of the State of New York. I understand and agree that this Agreement is intended to be as broad and inclusive as permitted by the laws of the State of New York and that the invalidity of any clause or provision will not otherwise affect the remaining clauses or provisions of this Agreement. I understand and agree that my electronic signature on this Agreement shall have the same binding legal effect as a handwritten signature to the fullest extent permitted by applicable law, including the Federal Electronic Signatures in Global and National Commerce Act and the New York State Electronic Signatures and Records Act, and I hereby waive any objection to the contrary.
Please confirm your agreement to the Other Matters statement
*
I agree
Confirmation
I acknowledge and agree that I have carefully read the clauses above and understand their terms and conditions. I understand that by typing my name in the box below I am signing this Agreement and consenting to all the terms and conditions listed above.
(
Please note that you must agree to these terms in order for your child to participate in Broadway Bound Kids programs.)
I,
Guardian/Parent Name
*
, certify that I am the legal guardian of the child listed below.
Child's Full Name
*
I further acknowledge and agree to the statements above.
*
I agree
Submit