Student Information & Waiver

Student Information and Waiver Form

Student's Name(Required)

Age(Required)

Student's School(Required)

Grade(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Home Phone #(Required)

Parent's Name(Required)

Tele (Day)(Required)

Email(Required)

Cell #(Required)

Allergies or Special Medical Conditions:(Required)

Emergency Contacts and Phone #'s(Required)

Pediatrician's Name(Required)

Pediatrician's Phone #(Required)

I, the undersigned, being the Parent/Guardian, certify that the enrolled student is in good health and has my permission to participate in the activities for this class and all Aurora Skills activities.

Furthermore, I certify that I release Aurora Skills Inc, its directors, and staff from liability for any medical or dental conditions that may arise while in attendance. I also grant consent and permission for any emergency treatment deemed necessary for my child. In the event of an emergency, I grant permission for care at the nearest hospital facility including private facilities.

Aurora Skills has the right to use photos and video taken during our classes for advertising and promotional purposes for future Aurora Skills classes and programs.

I understand that I will not be entitled to any refunds or deductions for any absences or illnesses during the term. Enrollment is not transferable between family and friends.

Most of Aurora Skills classes will transition from in-person to virtual if the need arises. Students enrolled will be able to attend one of the virtual classes.

Aurora Skills will not extend a refund, credit, or make-up days for class absences OR any class that has been cancelled due to any event that is out of Aurora Skills’ control. This includes but is not limited to pandemics, epidemics, sickness, school cancellations, weather, natural disasters, or any unforeseen occurrence.

Date(Required)

Relation to Child(Required)

The following people are authorized to pick up my child:(Required)

(It is the responsibility of the Parent/Guardian to notify Aurora Skills, in writing, if someone is not legally permitted to pick up your child(ren) from our programs.)

Prior notification must be given to Aurora Skills if someone other than the approved person(s) listed above will be picking the child(ren) up after the program.

By submitting this form, I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that submission of this form serves as my digital signature and that it indicates my acceptance of these terms.