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arc
Melrose Elementary
April 8 - May 29
AFTER SCHOOL ENRICHMENT CLASSES
ENROLLMENT DEADLINE: FRIDAY BEFORE CLASSES BEGIN
SCHEDULE
Wednesday SPRING CLASSES
Ballet, 2:30-3:30pm K-5
$100
Jazz, 3:30-4:30pm K-5
$100
Ballet
Soccer
Friday Ballet classes are designed to
develop students with a foundation
of ballet technique. This class
provides students with a FUN and
structured syllabus that enables
growth in the beautiful art of ballet.
Class is open to both girls and boys.
Does your child love soccer? In this
class, participants will improve their
athletic capacity by engaging in fun
games, technical skill development,
group activities, and friendly
competition.
Soccer, 2:30-3:30pm K-5
$100
Basketball, 3:30-4:30pm K-5
$100
Jazz
Jazz is a fun, upbeat dance class
for both boys and girls. Students will
grow in the areas of coordination,
rhythm, and self-confidence. Jazz
technique and choreography are
a great way to get your little one
moving. Students will present a
dance at the conclusion of the term.
IMPORTANT
DATES
4 / 8
5 / 29
Basketball
Students will improve their motor
skills while learning technical
skills of the game through fun
group activities, drills, and friendly
scrimmages.
CONTACT
Ariana Nunez
arc After School Site Coordinator
[email protected]
(310) 462-0350
ABOUT US
arc is an award-winning after school
and experiential education provider.
Classes Begin
Classes End
We bridge the opportunity gap by
creating transformational learning
opportunities that empower youth to
realize their full potential.
(310) 671-4400
www.arc-experience.com
□M
□F
Day
Total:
Cost
CV Code ___________
SIGNATURE __________________________________________________ DATE _____________________
My signature indicates that I have read this entire document and understand it completely and agree
to be bound by its terms.
City ______________________________________________ Zip _________________
Address of Card Holder __________________________________________________
Name on Card ____________________________________
Card Number _____________________________________ Exp. Date ___________
□ MC □ VISA □ AMEX □ Check #________ (Checks must be payable to “arc”)
Total: _____________________
PAYMENT INFORMATION
Class
REGISTRATION INFORMATION
MEDICAL NOTES: _________________________________________________________
ALLERGIES: ______________________________________________________________
REFUNDS: Refund requests are subject to a $45 processing fee. There will be NO
refunds given after the 1st week.
BEHAVIOR: arc reserves the right to dismiss participants whose behavior proves
disruptive to other participants. In such cases a consultation will be held with all
relevant parties before any action is taken. No refunds will be offered in such cases.
FILM & PHOTOGRAPHY: All photos or film taken in connection with the arc program
are the sole and exclusive property of arc and may be used in any promotional materials.
ENTIRE AGREEMENT: I understand that this is the entire Agreement between
myself and arc, its agents or employees, and that it cannot be modified or changed in
any way by the representatives or statements of any employees of arc or by me.
RELEASE: In consideration of the services and/or property provided, I, for myself
and any minor children for which I am the parent, legal guardian, or otherwise
responsible, any heirs, personal representatives, or assigns, do hereby release arc,
its principals, directors, officers, agents, employees, and volunteers from any and
all liability and waive any cause of action or complaint for any damage whatsoever
arising from any cause whatsoever (except that which is gross negligence). I further
agree to reimburse arc for all attorney’s fees and costs should I bring legal action
against arc and lose.
ACKNOWLEDGMENT AND ACCEPTANCE OF RISK: I understand and acknowledge
that the activities which I am about to voluntarily engage bear certain known risks
and unanticipated risks which could result in injury, death, illness or disease, physical
or mental, or damage to myself, to my property, or to spectators or other thirdparties. I accept and assume all responsibility and risk for injury, death, illness, or
disease, or damage to myself or to my property. My participation in this activity is
purely voluntary; no one is forcing me to participate, and I elect to participate in
spite of all known and unknown risks.
DUTY OF PARTICIPANTS: Some activities conducted by Good Sports Plus Ltd.
doing business as arc (hereinafter, “arc”) may be hazardous to participants. All
participants have a duty to act as a reasonably prudent person when engaging in the
activities offered by arc.
RELEASE OF LIABILITY AND ASSUMPTION OF RISK
EMERGENCY CONTACT: ___________________________________________ PHONE: ___________________________ ALT. PHONE: ___________________________
EMAIL: ________________________________________________________________________________________________________________________________________
ADDRESS: _____________________________________________________________________ CITY: ____________________________ ZIP CODE: _________________
PARENT/GUARDIAN: ______________________________________________ PHONE: ___________________________ ALT. PHONE: ___________________________
STUDENT NAME: _________________________________________________ ROOM: __________ GRADE: __________ DOB: _____________ GENDER:
arc ENRICHMENT ENROLLMENT FORM: MELROSE, SPRING 2015