Le Jardin Shine on Stage Spring 2020 Le Jardin Shine on Stage Spring 2020 Please fill out the form below to complete registration. Payment is due by 1/20. Mahalo!Student Name* First Last Grade*Is your child enrolled in Extended Day?*YesNoParent/Guardian* First Last Parent/Guardian Phone*Parent/Guardian Email* Enter Email Confirm Email Any Health Concerns to be aware of?Shine on Stage Classes*Shine classes will meet MONDAY AFTERNOONS *DATES FOR CLASS: 1/27, 2/3, 2/10, 2/24, 3/2, 3/16, 3/30, 4/6, 4/13, 4/20, 4/27, 5/4, 5/11 13 CLASSES TOTAL Shine on Stage for K-2 Grade from 3:00-4:00Shine on Stage for 3-6 Grade from 4:05-5:05Our K-2 Class is at capacity. Please email firstname.lastname@example.org to see if there are any spots or get on a waitlist! Thank you!*A gentle reminder that 3-4th graders who are not in the extended day program cannot be left unsupervised on campus before the 4:05pm class.*Please note that payment is for the full session with no drop ins. Once class has begun, there are no refunds or pro-rated amounts. Session must be payed for in full on or by January 20. Mahalo!Payment Type*Credit CardCheckCashPaypal: www.paypal.me/sarahjhalford/275Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name Payment is due by January 20th. Please mail check or cash payment to: Sarah Halford PO Box 1397 Kailua, HI 96734 Paypal users can follow this link: www.paypal.me/sarahjhalford/275 Total $0.00 Pick Up Procedure*Please fill out the pick up option for your child for after class. If this option changes, you can always email email@example.com.Due to the back to back class schedule, please ensure that grades K-2 children are picked up promptly at 4:00 -- Both classes have a 10 min max pick up window- after that a late charge will occur. If you are delayed, please text me at 808-721-2205. Mahalo!My child should be dropped back at Extended DayMy child should walk to the loop for pick-upPhoto Release*I hereby give Shine on Stage and Sarah Halford the permission to use my child’s photograph publicly to promote the Shine on Stage Performing Arts Program. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. I agree to allow my student to be in photos: I agree Liability Waiver*I allow my student to participate in classes and do herby release, forever discharge and agree to hold harmless Shine on Stage, its owners, directors, employees, volunteers from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may incurred by the student while involved in the classes. Furthermore, I, on behalf of my minor student, herby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreational actives involved therein. Yes No LOOKING FORWARD TO SHINING WITH YOU!