Youth Program Registration & Waiver

Complete this registration form for all participating children in your household. Children may be enrolled in multiple programs.

Parent / Legal Guardian Information

This information will automatically apply as primary contact for all registered children.

First Name *

Last Name *

Email Address *

Primary Phone Number *

Account Password *

Confirm Password *

Street Address *

City *

State *

Zip Code *

Secondary / Emergency Contact

Contact Full Name *

Phone Number *

Relationship to Youth *

Participating Children

Liability Waiver & Releases

SAPPHIRE YOUTH DEVELOPMENT CENTER, INC.

Youth Participation, Liability Waiver, Emergency Medical & Media Release

1. Acknowledgment & Assumption of Risk: I, the undersigned parent/guardian, understand that participation in programs conducted by Sapphire Youth Development Center, Inc. (SYDC)—including dance instruction, physical conditioning, performing arts, and mentorship—involves physical exertion and inherent risks (strains, sprains, accidental falls, or collisions). I affirm my registered child(ren) are in good health and voluntarily assume all risks associated with participation.

2. Release of Liability: In consideration of my child(ren) participating in SYDC activities, I hereby release, waive, and hold harmless Sapphire Youth Development Center, Inc., its board of directors, officers, instructors, employees, and volunteers from any claims, liabilities, or injuries arising from participation or ordinary negligence.

3. Emergency Medical Treatment: I authorize SYDC staff to secure first aid or emergency medical treatment for my child(ren) if I cannot be reached immediately. Primary medical insurance coverage remains my responsibility.

4. Personal Property: SYDC is not responsible for missing, lost, or damaged personal belongings brought onto SYDC premises or event locations.

I have read, understood, and agree to the Liability Waiver & Medical Release terms for 1 child. *

I agree to the Privacy Policy for 1 child. *

I agree to the Code of Conduct & reviewed it with 1 child. *

Media & Photo Release: I grant SYDC permission to photograph or video my child(ren) for promotional, grant, and website purposes. (Uncheck if you wish to OPT OUT).

Parent / Guardian E-Signature

Draw Your Signature Below *

Type Full Legal Name *

By typing your name and drawing above, you are providing a legal electronic signature binding this agreement.

At Sapphire Youth Development Center, we strive to maintain a safe, positive, and encouraging environment for all students, families, and staff. Please review our conduct expectations below.

Parent & Guardian Expectations

Respectful Communication: Maintain a respectful tone with instructors, staff, volunteers, and other families at all times.
Timely Drop-Off & Pick-Up: Ensure students arrive on time for scheduled classes/events and are picked up promptly at conclusion.
Supportive Environment: Encourage sportsmanlike behavior, active participation, and positive reinforcement.
Facility Courtesy: Keep waiting areas clean, supervise non-enrolled siblings, and adhere to facility safety guidelines.

Youth Participant Expectations

Respect & Kindness: Treat fellow students, teachers, and staff with kindness. Bullying, harassment, or name-calling will not be tolerated.
Active Engagement: Listen attentively to instructors, follow safety instructions, and put forth your best effort.
Care for Equipment: Treat center property, costumes, and equipment with care and respect.
Digital Responsibility: Refrain from unauthorized cell phone use or recording during program hours unless explicitly permitted.

Policy Acknowledgment: Failure to adhere to the Code of Conduct may result in temporary suspension or removal from programs without tuition refund.

Youth Program Registration & Waiver

Parent / Legal Guardian Information

Secondary / Emergency Contact

Participating Children

Liability Waiver & Releases

SAPPHIRE YOUTH DEVELOPMENT CENTER, INC.

Youth Participation, Liability Waiver, Emergency Medical & Media Release

Parent / Guardian E-Signature

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