Apollinaire Play Lab summer 2024
Class Registration Form
Single Week Programs
Each single week program runs Monday through Friday 9a-3p. For an extra charge early drop off (8a) and late pick up (4p) are available. Each week, young artists will explore a theme through a variety of visual and performing arts activities, games and classes. Each week will culminate in an arts exhibition and filmed performance. Open to ages 5-16. Participants will be grouped by age. Students must provide their own snack & lunch.
Rates for single week programs per week:
$395 for one student, $320 sibling rate, $95 Card to Culture rate for 1 student, $60 Card to Culture sibling rate.
Please select each single week you are registering for.
Week 1 (July 1-5): Magic
Week 2 (July 8-12): Myths and Legends
Week 3 (July 15-19): Science
Week 4 (July 22-26): Around the World
3 Week Long Summer Production Program
Apollinaire Play Lab’s Summer Production runs Monday through Friday 9a-3p for 3 weeks. For an extra charge early drop off (8a) and late pick up(4p) are available. Over the course of the program, students will rehearse a script, memorize lines and learn blocking. Students will also work on design elements like the set and costumes. Open to ages 5-16. Participants will be grouped by age.This program will culminate in a full performance. Students must provide their own snack & lunch.
Rates for 3 week long summer program:
$950 for one student, $875 sibling rate, $250 Card to Culture rate for 1 student, $210 Card to Culture sibling rate.
Please select here if you are registering for the 3 week long summer production.
July 29 - August 16 (no programming on Saturdays or Sundays)
Student's Name:
*
First Name
Last Name
Will you be adding a sibling/s?
*
Yes
No
Parent or Guardian's Names/s:
*
Address
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
*
Alternate Phone Number
Email
*
Additional/Alternate Email
Date of Birth
Age
Grade
Primary Language
Secondary Language
What school district does your child attend?
*
Does your child have any special needs? Physical, learning, health, developmental, etc.
If your child is 10 OR OLDER and you would like to give them permission to walk home themselves after their class/es, please indicate so here:
*
N/A- my child is under 10
YES, I do give permission for my child to walk home themselves
NO, my child does not have permission to walk home themselves and a parent/guardian will pick them up
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Sibling's Name
*
First Name
Last Name
Date of Birth
Age
Grade
If any parent/guardian information is different, or any contact information is different, please specify here.
Does your child have any special needs? Physical, learning, health, developmental, etc.
If your child is 10 OR OLDER and you would like to give them permission to walk home themselves after their class/es, please indicate so here:
*
N/A, my child is under 10
YES, I do give permission for my child to walk home themselves
NO, my child does not have permission to walk home themselves and a parent/guardian will pick them up
I will be adding another sibling
*
Yes
No
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Sibling's Name
*
First Name
Last Name
Date of Birth
Age
Grade
If any parent/guardian information is different, or any contact information is different, please specify here.
Does your child have any special needs? Physical, learning, health, developmental, etc.
If your child is 10 OR OLDER and you would like to give them permission to walk home themselves after their class/es, please indicate so here:
*
N/A, my child is under 10
Yes, I do give permission for my child to walk home themselves
NO, my child does not have permission to walk home themselves and a parent/guardian will pick them up
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Will you be
•Paying Full Price
•I have an EBT, WIC, or ConnectorCare Card and will be paying the Card to Culture rate
•Applying for Scholarship or Payment Plan (no EBT, WIC, or ConnectorCare card)
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Apollinaire Play Lab
Payment- If you have and EBT, WIC, or ConnectorCare card, please select the Card to Culture rates. If you are registering siblings, all students you are registering fall under the sibling rate.
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( X )
Single Week Tuition Per Week (select if registering 1 student) (please total all single week programs)
$
395.00
Quantity
1
2
3
4
Sibling Rate Single Week Tuition Per Week (select if registering multiple students) (please total all single week programs for all students)
$
320.00
Number of sibling rate weeks
1
2
3
4
5
6
7
8
EBT Rate for single week tuition per week (select if registering 1 student) (please total all single week programs)
$
95.00
Please bring your EBT, ConnectorCare, or WIC card to show on the first day of classes. Thank you!
Quantity
1
2
3
4
EBT Sibling rate for single week tuition per week (select if registering multiple students) (please total all single week programs for all students)
$
60.00
Please bring your EBT, ConnectorCare, or WIC card to show on the first day of classes. Thank you!
Number of sibling rate weeks
1
2
3
4
5
6
7
8
3 week Play Production Tuition (select if registering 1 student)
$
950.00
Sibling rate- 3 week Play Production Tuition (select if registering multiple students)
$
875.00
Number of Siblings
1
2
3
EBT rate- 3 week Production Program (select if registering 1 student)
$
250.00
Please bring your EBT, ConnectorCare, or WIC card to show on the first day of classes. Thank you!
EBT Sibling rate- 3 week Production Program (select if registering multiple students)
$
210.00
Please bring your EBT, ConnectorCare, or WIC card to show on the first day of classes. Thank you!
Number of siblings
1
2
3
Total
$
0.00
Credit Card
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Scholarship Application
For families requesting scholarship without an EBT, WIC, or ConnectorCare card.
Student's Name:
First Name
Last Name
Amount your family can contribute towards tuition:
Are you applying for a payment plan?
Please give a brief description of the family's financial situation:
Anything else we should know:
Once your application has been reviewed, we will contact you to confirm the scholarship amount that has been approved and to arrange for payment.
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Program Expectations & Release Form
Apollinaire Play Lab classes are designed for motivated student actors and artists. We ask that young people come each day ready to learn and engage in the program. Parents/Guardians will be contacted to problem-solve any issues concerning their child's participation.
*
I have read and understood the above.
Payments are non-refundable.
*
I have read and understand the above.
Students must be dropped off and picked up before and after class. The only exception is those students 10 years of age or older who have permission to walk home. Students may not wait unattended while other classes are in session.
*
I have read and understand the above.
If you are more than 10 minutes late picking up your child, there will be a $15 dollar fee and an additional $1 per minute, after the first 10 minutes. The fee needs to be paid before your child attends the following class.
*
I have read and understand the above.
In order to build a culture of collaboration and dedication, we ask that students attend all their classes. This is also crucial to preparing for their performances, both as individual artists and as members of a group performing together and counting on each other. Any scheduling conflicts will be communicated to Apollinaire Play Lab staff ahead of time. Excused absences will be given for family emergencies, illnesses, and presentation of COVID symptoms.
*
I have read and understand the above.
Photo/Video Release:
Occasionally, we take photographs and/or videos of students during classes and performances at Apollinaire Play Lab. We may use these images and videos in print publications that we produce, as well as on our website, or on display boards at the studio. Images and videos may also be used for newspaper advertisements or press releases. We will not use personal details of any person in a photographic image or video without prior specific permission not covered by this consent form. By submitting this form you consent to use of photographic images and video.
Illness:
If a child should become ill while attending the program, the parent or designated emergency contact will be notified immediately. It remains the responsibility of the parent to provide transportation for the child. For COVID protocols, we will be following the same guidelines as the Chelsea Public Schools, which are found here: https://www.chelseaschools.com/Page/2915
Accident:
In case of accident I agree to hold TheatreZone, Inc. dba Apollinaire Theatre Company and Apollinaire Play Lab and its instructors blameless and to refrain from legal action.
Further, I hold TheatreZone, Inc. dba Apollinaire Theatre Company and Apollinaire Play Lab and its employees in no way liable for any damage sustained to my child or his/her property while participating in the Apollinaire Play Lab Program.
By submitting this form, I accept the terms and conditions of enrollment for my child described above.
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Apollinaire Play Lab
Riseman Family Theatre • Chelsea Theatre Works, 187 Winnisimmet St. Chelsea, MA • apl@aplaylab.com • 617-615-6506 •
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