Mini Monet Art Studio


122 & 128 Main Street

Sayville NY 11782

631-218-9797

​MiniMonetNY@gmail.com



REGISTRATION FORM & WAIVER 


Every student that registers MUST have a registration form and waiver submitted (if you have already attended class or camp this school year then this is not necessary).  Parents must fill out complete form and sign the waiver. 

Please copy and paste the forms, sign, and either scan and email to minimonetny@gmail.com  Forms MUST be received prior to start of classes.


STUDENT NAME__________________________________________________

CLASS(S) ATTENDING_______________________________________________

AGE_____________

Grade ____________


Parent Name ____________________________________________________

Phone____________________________

Address_______________________________________

Email_________________________________________


Emergency Contact (other than registering parent)____________________________________________

Emergency Contact Phone________________________________________


Allergies_________________________________________________________________________________

Any other medical conditions or any other pertinent information______________________________________________________________

_____________________________________________________________________________________________________________________


​No food allowed during class but students are allowed to bring a water bottle.


CANCELLATION & REFUND POLICY

Please note-Mini Monet does not issue ​refunds for any of our classes. Students are allowed ONE missed class due to illness or emergency only!!!  Students may attend a different day of class they are registered for (must notify the studio ahead of time). If we do not offer a similar class during the week, we will offer a make-up day at the end of the 4 or 6 week session. Any class that is missed without notice is considered a "no show" & is not tracked; it cannot be made up and no credit will be given for that missed class. We must be notified PRIOR to missing class with either a phone call or email.  Credits will be issued on your account. It may only be used for other classes or events. It cannot be used to purchase merchandise.


ASSUMPTION OF RISK 
I hereby acknowledge, agree, and accept the risk of injury inherent in any physical activity or program, including particularly, the activities offered by Mini Monet. Such risks may include but are not limited to falling, bumping, risks from abrasions, scrapes, cuts, broken, sprained or bruised limbs, choking, injury to eyes, consumption or inhalation of paint or other media, allergic reactions, as well as risks from the actions or omissions of others.

COVID-19

I acknowledge the contagious nature of COVID-19 and by signing this waiver hereby voluntarily assume the risk I or my child(ren) may be exposed to or infected by COVID-19 by attending a Mini Monet program, especially in light of the fact that the program may be attended by several other persons, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. 

I understand that COVID-19 risk may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Mini Monet employees, volunteers, and program participants and their families. I acknowledge that while Mini Monet will exercise reasonable care in avoiding unnecessary exposure, it is impossible for Mini Monet to screen and/or monitor all individuals, and that it relies in good faith on representations from parents and caregivers about their health and that of their children. I agree to inform Mini Monet of any health concerns or changes of individuals in my household while participating in activities at Mini Monet that could impact the risk to its staff or others. 

MEDICAL CONDITIONS / ALLERGIES

Mini Monet exercises reasonable care and precautions to minimize the risk of food-related allergic reactions during summer or holiday camp snack time, including implementing, communicating, & enforcing strict no-nut snack policies; however, Mini Monet does not in any way ensure that the risks are completely mitigated, nor does it assume liability for any food-related allergic reactions. We require all children who are prescribed an epi-pen, inhaler, diabetic monitor or other medical device carry it with them at all times while on the premises. Parents/Guardians assume full responsibility for their child's allergies and other medical conditions.

RELEASE OF LIABILITY 

I hereby release, discharge, indemnify and hold harmless Mini Monet, its owners, members, managers, instructors, affiliates, agents, employees, successors and assigns, from any and all injuries, illnesses, medical conditions, medical care, death, damages, claims, liabilities, expenses or judgments, including attorneys' fees and court costs resulting from my, my child(ren)'s, or my child(ren)'s caregiver's participation in a program or presence on Mini Monet's premises or other location where Mini Monet may conduct art instruction, except as such may arise out of Mini Monet's gross negligence, and including whether a COVID-19 infection occurs before, during, or after participation in any Mini Monet.


​***Please note that we need at least 3 students for a class to run, classes may be cancelled in the event of no sign-ups


I give permission for photos to be taken and used for posting on social media yes_____ no______


SIGNATURE OF PARENT__________________________________________________

PRINT NAME___________________________________________________

NAME OF CHILD ATTENDING_________________________________________

Date:____________________________