SOME is a unique micro school, a collective of education professionals, experts,

and dedicated practitioners focused on teen education

LATE REGISTRATION PACKAGE FALL 2020

Location: 244 Elizabeth Street, 1C (Houston / Prince), NYC, 10012 Director: Krista Retto, 917-328-4759

https://www.iwoke.me/some

Registration is August 20th, 2020* - but we will accept forms until the 28th. *Late registration (September 1-4th, 2020) will adhere to a calendar of available courses as

posted on our website on 8/31/20 and payment will be due at the time of registration. There will be no discounts for 4+ electives and no special financial considerations for late registrees.

If you sent in an Interest Packet, your child/children will get first priority seats

between Aug 20 & 28th.

Send the completed form for each child to: myndfullnyc@gmail.com

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REGISTRATION INFORMATION FORM A. STUDENT INFORMATION (Please Print Clearly) Student’s Name _______________________________________________

Sex: Female_____ Male____ Has a laptop _____ Has a smartphone _____

Student’s Date of Birth _______________ Current Age_______ Parent/Guardians’ Name ___________________________________

Relation to Student _________________________________

Street___________________________________________________________

City____________________________________ State_______ Zip__________

Work Tel_______________________________

Cell Phone _____________________________

Email__________________________________________________________

Email2*__________________________________________________________ *Please list an email you are comfortable using for correspondence with your child's teachers. If same as above, write "same."

Emergency Contacts

1. Name & Phone* ______________________________________ *This person must be able to be reached during class hours. Relation____________________________________________ 2. Name & Phone ______________________________________ Relation____________________________________________ By initialing here, I authorize SOME to call an ambulance in case of emergency if/when a

parent or guardian cannot promptly pick up their child, and thereby release SOME as per the Release Form. I understand I will incur all costs of emergency care. ___________

If enrolling more than one child, a form must be filled out for each.

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B. REGISTRATION & PAYMENT INFORMATION Registration is first-come, first-serve. Priority seating given to those who submitted the Interest Packet in the order of date received, and secondarily to those who submit signed registration forms. Enrollment is only guaranteed, of course, after payment is received and a receipt to you is supplied. Should a class not have enough or too many enrolled during time of payment, you will be contacted immediately with an option to switch or receive full refund(s). C. ENROLLMENT DEADLINES

Registration Form Due: Aug 1-Aug 20 1/2 Payment Due: Aug 20-Aug 28 Late Registration: Sept 1-4 Registration/Release Forms & ½ Payment Due Balance Due: October 1, 2020

D. LATE ENROLLMENT & FEES Core tuition is $600 and includes two (2) core classes for each child. If desired, a third core class is $100. SAT courses are $400 for the term. All other electives are $200 per class for the term. No discounts will be given during late registration.

Ø Please list your final selections in the white boxes, meaning list those courses you warrant you will pay for if class not cancelled due to low enrollment. Clearly state the day/time of each class, not just course name.

Ø If there are classes you are considering but you might not pay for even if available, list those in the grey boxes. These are your alternates if a class gets cancelled, so list them in preference order.

CLASS NAME Preferred Day/Time Other Possible

Day/Time Fee

(core) (core)

ALTERNATE CLASS Preferred Day/Time Note

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D. ADDITIONAL POLICIES

Payment Policy: The parent/guardian of the child enrolled in SOME is responsible for full payment of the tuition. I understand that payments listed in C. above must be sent via Zelle (Krista Retto, 917-328-4759, Bank of America) or Venmo (@Krista-Retto) and that Krista is collecting on behalf of all tutors. Any other arrangements must be cleared in writing prior to August 20th. Tuition and fees cannot be transferred from one student to another. I understand that after submitting this form, and by August 28th, I will receive written correspondence confirming or denying enrollment for each requested class. Once contacted, I understand I must pay on time or I might lose enrollment in any requested class. Withdrawal/Refund Policy During Term: Written notification to myndfullnyc@gmail.com is required for a refund to withdraw a child from the program during the term (notifying the instructor is not acceptable). Refunds will be pro-rated from the date of receipt of withdrawal or dismal beginning no earlier than one-half of the semester term. If a class is cancelled prior to the term start, a full refund will be given. )E. AUTHORIZE and SUBMIT I hereby warrant that I am the parent or legal guardian of Student and have full authority to execute this three-page Registration Information Form, which I have read, understand and approve. I hereby agree that both Student and I shall be bound to terms stated on this Registration Form. Parent Name________________________________________________ Signature __________________________________________________ Date______________________

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Agreement & Release of Liability

Liability & Indemnity: I (aka "Parent," "I," "Myself"), on behalf of myself and as legal guardian of Student, and for Student’s executors and administrators, do hereby exempt, release, and forever discharge 244-246 Elizabeth Street HDFC (“Premises”) and its directors, officers, agents, employees and instructors from making claim or taking proceedings, and hereby waive any and all claims or contribution which may occur, from any cause whatsoever during or arising from Student’s participation in the collective tutoring program currently entitled and hereinafter referred to as "SOME" (aka "Classes"), including any illness or injury of any manner to Student or Student’s guests, as well as from any damage, theft or loss to Student’s property or Student’s guests’ property. Physical Condition Certification: I, on behalf of Student, hereby certify that Student is reasonably suited to participate in the Classes and Student does not have any physical impairment that would adversely affect Student’s participation in the Classes. I do / do not want (please circle) my child to wear a mask or other face covering during classes. Health concerns for my child are: Media Release: I, on behalf of myself and Student, for good and valuable consideration, receipt and sufficiency of which is hereby acknowledged, hereby grant to SOME, and to other such persons as SOME may designate from time to time, the absolute right and permission to use in perpetuity student’s likeness, voice, name, photographs, video and/or images (“Persona”) in whole or in part, or distorted in character or form, either alone or accompanied by other material, throughout the world, in perpetuity and royalty-free, for any purpose in any media now known or ever developed in the future, including but not limited to documentary projects, television broadcast, news coverage, entertainment and current affairs

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programming, Internet broadcast, podcasts, streaming video advertising, promotion, publicity, marketing and/or other trade materials (the “Materials”) excluding all uses that may endanger the Student. I waive all rights to compensation for use of student’s Persona. I understand that SOME shall have complete ownership over the Materials and own all right, title and interest, including without limitation all copyrights, trademark rights and property rights, in and to the Materials and hereby waive on behalf all rights to inspect and approve the Materials, its use or such written or spoken copy as may be used in connection therewith. I agree that I will not hold SOME or anyone who receives permission from SOME, responsible for any liability resulting from the use of student’s Persona in accordance with the terms hereof, excluding claims for defamation or child abuse of any kind whatsoever. I hereby warrant that I am the parent or legal guardian of Student and have full authority to execute this two page Registration and Release Form, which I have read, understand and approve. I hereby agree that both Student and I shall be bound to terms stated on this Release Form. This two-page Agreement & Release of Liability form will be construed

in accordance with and governed by the laws of the State of New York. Full Parent Name________________________________________ Parent Signature ________________________________________ Date__________________ Student Name ________________________________________________

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INFORMED CONSENT FOR IN-PERSON EDUCATIONAL SERVICES DURING

COVID-19 PUBLIC HEALTH CRISIS

Parties & Parties Understanding

"You" and "Your(s)" meaning the parent or legal guardian executing this document on behalf

of all legal guardians for the "Student" cited within this document.

"We," "Our(s)" and "Us" includes the tutors and instructors of classes within the collective

tutoring program called "SOME" and the 244-246 Elizabeth Street HDFC (“Premises”) and

its directors, officers, agents, employees, and shareholders.

Collectively, "You" and "We" shall be called "The Parties."

This document contains specific and important information about our decision (yours and

ours) to submit your legal dependent for in-person classes in light of the COVID-19 public

health crisis. Please read this carefully and, prior to signing, present any questions. When you

sign this document, it will be an official agreement between The Parties.

Decision to In-Person

We have agreed the Student and We shall meet in person for one or more future classes in the

fall, 2020 in SOME. If there is a resurgence of the pandemic or if other health concerns arise,

however, We may require at our sole discretion that classes cease at the Premises and be held

via private online classes.

If You decide at any time that You would feel safer for the Student to attend classes

exclusively by attending online, We will respect that decision and agree to accommodate

dial-in during scheduled class time(s).

Risks of Opting for In-Person Services

You understand that by the Student's attending physically-held classes, You are solely

assuming the risk of exposure to the coronavirus (or other public health risk). You also

understand this risk may increase if public transportation, cab, or ridesharing service to and

from classes are utilized.

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Your Responsibility to Minimize Exposure

To obtain services in person, You and Student agree to take certain precautions which will

help keep everyone (You, Us, and our families, and other persons on the Premises) safer

from exposure, sickness and possible death. If You do not adhere to these safeguards, it may

result in enforcing a digital attendance arrangement.

Our Commitment to Minimize Exposure

SOME instructors will take steps to reduce the risk of spreading the coronavirus within the

classrooms such as regularly sanitizing all common area handles and knobs, providing

sanitizing wipes, providing individualized supplies. Please let Us know if You have questions

about these efforts.

If You or We Are Sick

If You or Student arrive at the Premises and we believe that precautions and guidelines are

not being followed, or believe You or Student to have been exposed, We retain the right to

require You to pick up the Student promptly. Students may have their temperature taken on

Premises and instructors may also be checked.

If You or anyone in your known circle has tested positive, We require notification and,

conversely, if We or any other Student tests positive for the coronavirus, We will promptly

notify You so that You can take appropriate precautions.

Your Confidentiality in the Case of Infection

If You or anyone You divulge has tested positive for the coronavirus, We may be required to

notify local health authorities but agree We will only provide the minimum information

necessary for their data collection and as required by law.

Informed Consent

This three-page agreement supplements any other agreement The Parties may have signed.

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Initial each to indicate that You understand and agree to these actions:

• Student will only attend class if he/she is symptom free. ___

• You will take Student's temperature before coming to each class as/if recommended by law.

If it is elevated (100 Fahrenheit or more), or if You notice other symptoms of the

coronavirus, You agree Student will not attend class in person. ___

• Student will not arrive more than 10 minutes before class, and will leave no later than 10

minutes after completion of classes for the day. ___

• You and Student will wash Your hands or use alcohol-based hand sanitizer when You enter

the building. ___

• You will instruct Student on the importance of coughing or sneezing into his/her arm and to

do their best not to touch their face while on Premises. ___

• You and Student will adhere to the safe distancing precautions between the other children

and the instructors as required by law during the Classes.___

• Your Student will wear a mask if required by law. Note that instructors will also wear a

mask as required by law and/or may opt to wear one even if not required. ___

• There will be no physical contact such as shaking hands between Students nor between

instructor and Student(s). ___

• If requested by Us, Student agrees to immediately wash or sanitize his/her hands and on

using the bathroom or kitchen, Student(s) are expected to wipe down surfaces.___

• If a resident or guest of Your home tests positive for the infection, You will immediately let

Us know.___

We may change the above precautions if additional local, state or federal orders or guidelines

are published. We will advise about any necessary changes.

This three-page Informed Consent will be construed in accordance with and governed by the laws of the State of New York. Full Parent Name________________________________________ Parent Signature ________________________________________ Date__________ Student Name ____________________________________________