WAMA Strings Registration

"*" indicates required fields

Student Information

Student's Name*

First Last

Student's Date of Birth*

Grade (2023-24)*

Student's School*

Student's Gender*

Student's Address*

Street Address Address Line 2 City State ZIP Code

Student's Email

Primary Parent/Guardian Information

Parent/Guardian's Name*

First Last

Address

If different from above.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Primary phone number - home or cell

Email*

Program & Session

Registration ($25) and Tuition Fees ($125) are due no later than the first day of the session your student is attending, and can be paid with cash, credit or debit card (www.wildwoodpark.org), or by check made out to Wildwood Park for the Arts with your student’s name and WAMA session in the memo line. Registration Fees are nonrefundable.

Special Considerations

Does your student have any medical conditions, learning difficulties, special needs, or other conditions that are addressed in their school program? If so, please provide details:

List all medications and allergies:

Photo & Video Release

Park and Program staff will take photos and videos of students. These pictures can be used for inside marketing (bulletin boards etc.) or outside marketing (brochures, website, print ads, etc.) for official Wildwood Park for the Arts and Wildwood Academy of Music and the Arts business.

Children’s names are never used. In the event we are in a position that requires the children’s names included with the photo – usually for press releases to the local papers, we will notify you and will require additional consent from you. This release is for ‘no name included’ photos.

Liability Release

By registering for and/or attending classes, camps, activities, and/or other programs at Wildwood Park for the Arts, and/or using the premises, facilities, and equipment (collectively, Classes and Facilities) of Wildwood Park for the Arts, I hereby agree that there are certain inherent risks and dangers in exercise and in using indoor/outdoor theatrical, exercise, and performance equipment in association with the Classes and Facilities, and risk of transmission of illness during group activities.

In consideration of being allowed to participate in and access the Classes and Facilities provided by Wildwood Park for the Arts, in addition to the payment of any fee or charge, I hereby (1) agree to assume full responsibility for any and all injuries, damage, or illness which are sustained or aggravated in relation to classes and facilities, (2) waive, release, and forever discharge Wildwood Park for the Arts, its officers, agents, members, employees, representatives, and all others from any and all responsibility, claims, rights, causes of action, and/or liability from injuries, damage, or spread of illness to my person or property and/or the person or property of my child resulting your participation in/use of classes and facilities, and (3) represent that I/my child have no medical or physical condition preventing me/my child from attending and/or using any of Wildwood Park for the Arts’ classes and facilities and/or put me/my child in any physical or medical danger, and have not been instructed by a physician not to do so.

Phone

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