Melanie Thornton Youth Arts Foundation

Note: If you are registering for one of the United Programs ( Martial Arts, Dance, Music, Drama) conducted at one of our many preschool or childcare sites, then you are at the correct page. If you are registering for the Martial Arts Program 10-25 Program at New Mercies Christian Christian Church, then please go to the Martial Arts 10-25 Program Page.


Class enrolling in
School/location
Registration date

Name (first/last)
Birthdate	/	/


Name (title, first, last, suffix)
Street address
City	State	Zip
Best contact phone#


Please list any special needs or circumstances that might arise for your child such as; food or drug allergies, physical or emotional difficuties or limitations, prescription drugs taken, etc.:
Emergency Contact #

Program rules and advisory: I hereby give approval for the participation of my child in the above indicated program and assume all risks and hazardous incidents to such participation. I waive, release, absolve, indemnify and agree to hold harmless The Melanie Thornton Youth Arts Foundation and United Programs hereafter referred to as “The Progam” and the center where these classes are held, affiliated associations, orgnaizers, officers, teachers, assistants, parents, and participants from any claim arising out of injury to my child I further grant to the program the right to photograph and or video record me or my child and further use my or my child’s name, face, likeness, voice and apperance in cinnection with exhibitions, publicity, advertising, and promotional materials without reservation or limitation within the limits of the established laws and practices.
I have read the program rules and advisory and give consent for my child to participate *	I approve I do NOT approve

Additional registration and Payment information

Participants can receive a refund of 50% if requested in writing if there is a medical / physical injury / illness or a family emergency precluding participation. The refund will be prorated based on the number of weeks remaining in the session.

No refunds will be issued due to the child's unwillingness to attend / participate.