Symbolic Art
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    • Symbolic Art Sports Program
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    • William R. Lummis ES
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    • Molasky MS
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SYMBOLIC ART @MOLASKY MS

    PROGRAM REGISTRATION FORM *MOLASKY MS 
    Please Note: "Required" fields followed by an asterisk must be filled in

    Insert information for the child to be enrolled in the Symbolic Art program
    Insert information for the siblings to be enrolled in the Symbolic Art program

    The "Enrolling Parent or Guardian" is the only person who can make changes related to child(ren)
    instructions: The "Enrolling" Parent/Guardian is the only person who can submit changes to emergency contact information
    Designated persons who pick up "MUST" be prepared to show an approved I.D. upon request

    Fee Disclosure*

    An 'annual' registration fee: $25 is required for each new participant enrolled in Symbolic Art programs; Symbolic Art fees can be made: Daily, Weekly or Monthly *Symbolic Art participants are eligible to attend "Free" workshops throughout the week. *Enrollment 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 6:30 p.m. (e.g. 6:45 pm / pick up = +$10)

    Sign-In & Sign-Out

    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.
    Children "will not" be released without proper identification "and" prior written authorization from 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)

    Waiver of Claim*

    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 dba, "Symbolic Art" and their respective officers, employees, agents or representatives from any and all liability for personal injury or damages, sustained, incurred, arising from 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 4-14. During programs or events Symbolic Art staff may take photos of participants that may be used in professionally designed publications, websites, promotional materials and social media platforms.

    Parent Letter*

    I have received, read and understand the contents of the parent letter

    Please Type Your Name Acknowledging You
    Accept Symbolic Art Terms & Conditions*

SUBMIT REGISTRATION FORM
The Symbolic Art Learning Center
2402 N. Tenaya Way
Las Vegas, NV 89128
SymbolicArtCenter@gmail.com

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Symbolic Art 2019  
  • Symbolic Art Programs
    • Symbolic Art Sports Program
    • Richard H. Bryan ES
    • William R. Lummis ES
    • Ernest Becker MS
    • Molasky MS
    • Club Teach
  • Activities & Events
  • The Learning Center
    • Programs at TLC >
      • Computer Based Learning
      • Toddler Sports
      • Youth Activities & Events >
        • Kids Night Out
        • Holiday "Elf" Workshop
  • In The Community
    • Symbolic Art BINGO
  • CAMPS FOR KIDS, SUMMERLIN
  • About Us
  • Donation
  • Hip Hop Festival, 2019