Saturday Program Registration

  • Instructions: Please complete this registration form for each child you are registering.

    Student's Date of Birth(Required)

    Choose Your Saturday Improv Class(Required)
    Each class is 10 weeks/session, from January 14 through March 18
    2 payments of $175.00 billed the 1st of each month will be processed. If your student is new to us we will also process a non-refundable first-time processing fee of $35.00.

    Emergency Contact Information

    Please provide preferred phone numbers and email addresses for parents/caregivers.



    Does the student have any special physical (including allergies), behavioral, learning and/or other needs our staff should be aware of?


    Payment

    Select a payment method(Required)
    2 payments of $175.00 billed the 1st of each month will be processed. If your student is new to us we will also process a non-refundable first-time processing fee of $35.00.

    Payment and Cancellation Policy (Non-Negotiable)

    • I understand there is a one-time, non-refundable processing fee of $35.00 for each new student.
    • I understand that $175.00 will be charged automatically on September 1 and October 1 using the payment method on file.
    • I understand there is a $40.00 fee for any rejected debit from your financial institution.
    • I understand there is a late pick-up charge of $25.00 per every 10 minutes late; automatically charged.
    • I consent to ILS keeping my signature on file to initiate a debit or credit card transaction on an ongoing basis in the amount due for session tuition payments and fees.
    • I understand that withdrawal must be submitted in writing, via email and will be acknowledged within a 14-days of the start of the session.

    Medical Consent  I hereby consent to allow ILS to seek emergency medical treatment, including ambulatory transport if required, for the child named on this registration. I authorize first-aid care as necessary to preserve the life, limb and well-being of my child. If it is necessary for the child to be transported to receive emergency care at Children's Hospital, I will be responsible for all charges not covered by insurance. I consent for the emergency contact listed on the registration form to ACT ON MY BEHALF until I am available. I agree to review and update this information whenever a change occurs.

    Removal from Program due to Behavioral Issues  I understand that ILS has a Zero Tolerance Policy for bullying and children who do not comply may be asked to leave immediately without refund if behavior cannot be reasonably corrected.

    Photo Release Agreement  I understand that from time to time Illumination Learning Studio takes photos of students engaged in its programs for use on their social media or on their website. While photos are used exclusively without identifying a student's name or other personal information or age, I understand that I may request any photo be taken down.

    Agreement(Required)