CAC’s After School Program
Application Form:

November 4-December 19, no class November 27&28

Thank you to the County Executive Support Grant and Prue Clendenning for support of after-school programs.

Student Name

First Name

Last Name

Student Date of Birth

School

Grade

Any medical or developmental conditions we should be aware of?

Parent Name

First Name

Last Name

Parent Email

Phone

(###)

###

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Additional Emergency Contact Name & Relationship

First Name

Last Name

Additional Emergency Contact Phone Number

(###)

###

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Please list the name of adults besides yourself that are permitted to pick up your child:

ID will be required

Which programs are you interested in?

Wed: Dance (Grades 3-5)

Thurs: Ceramics (Grades 3-5)

Thurs: Visual Art (Grades 1-2)

Which program is your first choice?

Which program is your second choice?

Please read and acknowledge the following policies:

Student Behavior Policy – CAC reserves the right to cancel or refuse the registration of a student in a class or workshop if participation by the student is deemed disruptive or interferes with the learning atmosphere and enjoyment of the class/workshop. Photograph Release – I (the undersigned) hereby grant CAC the right to photograph me or my child during classes and performances, and to use my or their image, photograph, silhouette and other reproductions of their physical likeness in connection with ongoing CAC publicity. I agree that I will not assert or maintain against CAC their successors, assigns and licensees, any claim, action, suit or demand of any kind or nature whatsoever, including but not limited to those grounded upon invasion of privacy, rights of publicity or other civil rights, or for any reason in connection with CAC’s authorized use of my child’s physical likeness for CAC publicity purposes. By my signature here I understand that I agree to the above mentioned guidelines and completely turn over all rights to the still photographs to the CAC. Release, Waiver of Liability, and Indemnity Agreement – I (the undersigned) hereby agree with the Chesapeake Arts Center, Inc. (CAC) to the following by affixing my signature below on this date. In connection with my participation in the CAC program, I understand and acknowledge the nature and extent of the activities that will be involved in the Program and assume the risk inherent in such activities on behalf of myself and any minor children. I voluntarily waive any and all claims, costs, liabilities, expenses (including attorney’s fees), and judgments against CAC, its directors, officers, employees, servants, subcontractors, and agents and hereby release, excuse and discharge CAC, its directors, officers, employees, servants, subcontractors, and agents from all claims, costs, liabilities, expenses (including attorney’s fee), and judgments which may arise out of my participation in the Program and all aspects attendant thereto. The undersigned further agrees to indemnify and hold CAC, its directors, officers, employees, servants, subcontractors, and agents harmless from any and all claims, damages, actions, liabilities, expenses (including attorney’s fees) and judgments that may arise out of my participation with the Program. Covid-19/Illness Policy - Please do NOT come to class if you, or anyone in your household, are experiencing any covid symptoms (includes any of the following: chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea. Please visit chesapeakearts.org/cares for our complete Covid-19 safety policy. Closings/Cancellations - CAC follows the AACPS school system. If AACPS is closed for a holiday, or weather, the CAC after school program is cancelled for that day and evening. If classes are closed due to weather, instructors are required to verify closure with CAC and then notify students via the email provided on this application. BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ THESE POLICIES:

The after school program at CAC is available to students in grades 1-5 in Anne Arundel County.

We are now accepting applications for our 2nd Session!

Transportation is not provided.

There is no fee to attend, and students will be admitted on a first-come, first-serve basis.

To apply, please fill out the form here and CAC staff will be in touch with enrollment confirmation. Students will be initially admitted to one program. If space allows, students may be invited to attend on another day as well. Please do not arrive for After School Clubs if you have not received a confirmation from our staff.

Program Descriptions

Dance Club - Grades 3-5 (Wednesdays with Robin Miller): Let's get moving! Students will explore various styles of movement such as jazz, ballet, and musical theater. Students learn endurance and flexibility training while finding their inner artistry.

Ceramics Club - Grades 3-5 (Thursdays with Nadia Lezcano): Let's create with clay! Explore this fun, versatile medium while making your own sculptures and pottery.

Visual Art - Grades 1-2 (Thursdays with Kayla Williams): Dive into a series of exciting hands-on projects! This fun class introduces techniques in drawing, painting and collage.

Pick Up & Drop Off Procedures

Drop off: The entrance to our main building is located towards the back of the parking lot when you turn into the parking lot from Hammonds Lane. Go all the way to the back to the last building and look for the blue awning and sign that says Chesapeake Arts Center. Please enter the building with your child, and take them directly to their classroom. There is no bus transportation.

Pick up: Pick up from CAC is at 5:15pm. Please enter CAC through the same door as drop off to collect your child from their classroom. Your child's instructor will greet you and ask for your ID. If someone besides yourself will be retrieving your child, please let the instructor know at drop-off. We will only release students to those on their approved list, with ID. Please be on time. (Repeated late pick-up may result in removal from the after school club). Thanks in advance for your cooperation.

CAC’s After School Program
Application Form:

November 4-December 19, no class November 27&28

Program Descriptions

Pick Up & Drop Off Procedures

CAC HOURS

CONTACT

ADDRESS

RESOURCES

CAC’s After School ProgramApplication Form:

November 4-December 19, no class November 27&28

Program Descriptions

Pick Up & Drop Off Procedures

CAC HOURS

CONTACT

ADDRESS

RESOURCES

CAC’s After School Program
Application Form: