Online registration

Sports & Recreation Program
@Becker Middle School

Please note that all fields followed by an asterisk must be filled in.
Symbolic Art Basketball
Aerobics Exercise & Fitness
Dance & Choreography
Symbolic Art Basketball
Aerobics Exercise & Fitness
Dance & Choreography
Program Registration Fees are "Non Refundable" in the event participant is absent from the program. Payments may be made in cash, money order, Paypal or credit card. Payments will only be accepted from adults listed on this form.

A $10 late fee will be assessed for each :15 minutes past the end of the session

To protect the safety of our children I understand each child must be signed in and out daily. The only person(s) authorized to pick up the child(ren) are those listed on this form; photo ID must be shown until Symbolic Art staff becomes familiar with the identity of designated person(s) picking up. Children "will not" be released without proper identification "and" prior written authorization from the enrolling parent/guardian. *Authorization via Email is acceptable. In the case of joint custody disputes Symbolic Art staff will comply "Only" with "Written" instructions directed by court order on file with Symbolic Art (if applicable)
For ourselves, and/or on behalf of our child named above, our heirs, affiliates, executors, and administrators, we hereby do expressly and forever waive and release Symbolic Art Central, Inc and their respective officers, employees, agents or representatives from any and all liability for personal injury or damages, sustained, incurred, arising from participating in our programming and/or connected with travel to, return from any and all classes, tournaments and/or special events, and all activities related to, or in connection with said activity by ourselves or by our child. *Symbolic Art is a community based organization focused on making sports, recreation and artistic expression fun for youth ages 4-16. During programs or events Symbolic Art staff may take photos of participants that may be used in professionally designed publications and promotional materials