A.B.C. Play Registration

A.B.C Play! Registration Form
I am registering for... *
Student's Name *

First Name Last Name
Student's Date of Birth *

Month Day Year
Date
Parent/Guardian's Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number (to be contacted on day of class) *
Please enter a valid phone number.
Secondary Phone Number *
Please enter a valid phone number.
Primary Language Spoken at Home *
Tell us about your child! We strive to create an environment in which all students can have fun, be comfortable playing during both structured and unstructured play time, and have a successful group experience. Please share anything you would like us to know about your child (personality, learning style, favorite activities, etc.). If you would like to discuss further, please don't hesitate to contact us directly via phone or email. *

Emergency Information

We collect medical information for all in-person and virtual services. The information provided would be used should we need to contact emergency services during your time with us.
Please list any allergies. Write "N/A" if none. *
Do you have an epi-pen? *

Yes No
Emergency Contact Name *

First Name Last Name
Emergency Contact Relation to Student *
Emergency Contact Phone *
Please enter a valid phone number.
Medical Attention

In the event of an emergency requiring medical attention, I understand that Sing Explore Create, LLC will make every effort to contact and notify the listed parent/guardian and emergency contact listed above. However, if neither can be reached Sing Explore Create, LLC reserves the right to call emergency personnel to transport the student/client to the nearest medical facility to secure necessary medical treatment. This applies to sessions at our center, at-home visits, and online sessions.
*

I have read and agree to the above statement regarding medical attention.
Pick-Up Policy: For students under age 18, we reserve the right to ask for picture identification from anyone picking up students from Sing Explore Create, LLC studios. Only those who have been given written permission from the students' parent/guardian will be allowed to pick up. Please list the names of those who may be picking up the student below. In the event that a student must be picked up by someone not listed below, hand-written notification and permission from the parent/guardian must be given to the teacher prior to the student being dismissed. *

Covid Guidelines

Like so many, we are excited to be even closer to "normal" life again here at SEC. Please see our most updated health and safety policies below. We appreciate your understanding that our services fall under many categories, given that we provide both recreational and therapy services for all ages. The policies below were created after thoroughly reviewing guidelines from Governor Baker's office, Department of Ed., Department of Early Education and Care, and Department of Developmental Services. We will continue to review and update our policies as necessary. Updates may be found at: https://singexplorecreate.com/covid-19-response/
Facemasks

Facemasks are required in our center for unvaccinated adult and participants and staff in our Thursday, 1-3pm Creative Arts Wellness program for adults. Facemasks are optional in our center for childre and vaccinated teens and adults (including staff). SEC staff will continue to wear a mask in private music therapy or private music lessons if requested by the student or music therapy client.

Hand Hygiene

All visitors (including staff) are required to wash their hands with soap and water or use hand sanitizer upon arrival. SEC Staff are required to wash/sanitize their hands between each group or individual session.

Screening for illness

We ask that you do not enter the center if you are sick. If you are sick or required to quarantine for any reason, please contact us to postpone your services or arrange for virtual services until it is safe for you to return to the center. If any visitor gets sick while at the center, SEC staff will guide them to a separate area away from others until they are picked up or able to safely leave on their own. Caregivers will be contacts immediately if an individual becomes sick in our center and needs to be picked up.

Cleaning

All surfaces, instruments, and other materials are cleaned between every session. Bathrooms and common areas are regularly cleaned throughout the week.

Air Quality

HEPA air filters are operating in every room and our HVAC system is updated and operating with maximum outdoor air exchange.

Use of Instruments/Materials

Group participants will be allowed to share instruments and materials. Any item that is “mouthed” or otherwise contaminated will immediately be removed from group use and fully disinfected or disposed of appropriately after the group.

Pick Up/Drop Off

Please make every effort to pick up/drop off in a timely manner. Staff need the scheduled time in between sessions to properly clean for the next student’s arrival. Please do not enter the center before your scheduled time. Frequent late pick ups may result in losing your scheduled timeslot or additional fees.
By checking below I certify that: *

I have read and agree to the policies and information provided above I will adhere to all health and safety policies of Sing Explore Create, LLC (subject to change based on most current CDC and state guidelines)
Enter your name below. This will serve as your electronic signature, and indicates that you agree to the above terms and conditions. Parents/Guardians may sign on behalf of their children. *
Name (Electronic Signature)

Media Permissions

At times we may take pictures, videos, and audio recordings during classes/sessions. We utilize recorded media for marketing and professional development purposes.For marketing, recorded media may be shared to our website, professional Facebook page, and used to produce other marketing materials (brochures, newspaper articles, etc).For professional development, recorded media is NOT shared with the public. Recorded media is viewed only by staff members at Sing Explore Create for educational purposes.Please indicate your preferences below:
I give permission for Sing Explore Create, LLC to record AUDIO during classes/sessions for the following purposes: *

Marketing AND Professional Development Professional Development ONLY I DECLINE permission for Sing Explore Create to record audio
I give permission for Sing Explore Create, LLC to record VIDEO during classes/sessions for the following purposes: *

Marketing AND Professional Development Professional Development ONLY I DECLINE permission for Sing Explore Create to record video
I give permission for Sing Explore Create, LLC to take PICTURES during classes/sessions for the following purposes: *

Marketing AND Professional Development Professional Development ONLY I DECLINE permission for Sing Explore Create to take pictures
Should be Empty:

A.B.C Play! Registration Form

Emergency Information

Covid Guidelines

Media Permissions