Complete this registration form for the upcoming Fall Cycle 2023 beginning September 2023 NOTE: Items marked with * are required. In order to reserve a space for a student, paying online immediately after submitting this form is strongly recommended, as most classes have limited seating. All students must make a payment in the form of cash or money order at the center if payment is not made online. If you can't pay online, please visit the center as soon as possible to make a payment to reserve your space. Programs run on 8 Week Cycles (Summer Cycle is 4 Weeks) CHILDREN (ages 2-19) Music Class fees 1 Music Class = $25 2 Music Classes = $50 3 Music Classes = $75 Coding Class (Code the Bronx) fee FREE - More information at initial orientation ADULTS Music Class fees $100 per Class Registration Cycle * Co-Op City Co-Op City Saturday Classes (Ages 6-19 only): September 16, 2023 - October 27, 2023 Drums: 11:30am - 12:30pm Guitar: 12:30pm - 1:30pm Keyboard: 10:30am - 11:30am Vocals: 9:30am - 10:30am Dance: 10:30am - 11:30am Registration Cycle * Fall Cycle 2023: Monday Night Hoops September 18, 2023 - Evenings Fall Cycle 2023: Wednesday Music Class - Evenings Fall Cycle 2023: Co-Op City Saturday Classes (Ages 6-19 only) Renaissance Youth Center Select one below, then select the class(es) you wish your child to attend. Private Music Classes (Appointment Only) available at $10 per half hour for children $20 per half hour for adults Tutoring Only $25 per cycle (8 weeks) September 16, 2023 - October 28, 2023 Fall Cycle 2023: Saturday Coding Class (Code the Bronx) TBD - TBD Daytime { Orientation TBD } Adult Vocals & Music Class Thursdays, *ADULTS ONLY* Fall Cycle 2023: Friday Night Hoops (Saturday for Toddlers) September 15, 2023 - October 27, 2023 Evenings Fall Cycle 2023: Friday Music Class September 15, 2023 - October 27, 2023 Evenings Fall Cycle 2023: Saturday Music Class September 16, 2023 - October 28, 2023 Daytime Fall Cycle 2023: Saturdays - Score "2" for Autism Basketball Program (Toddlers Ages 4-12) September 16, 2023 - October 28, 2023 2:15pm - 3:15pm Monday Night Hoops Basketball is located at 890 Cauldwell Ave., Gym located in M.S. 301 Hoops Nights Boys & Girls Ages 6-12 Monday @ 6:30pm-7:45pm Boys & Girls Ages 13-18 Monday @ 7:45pm-9:00pm Friday Night Hoops Basketball is located at 890 Cauldwell Ave., Gym located in M.S. 301 Hoops Nights (Saturday afternoon for Toddlers) Boys & Girls Ages 2-5 Saturday @ 1:30pm-2:15pm Boys & Girls Ages 6-12 Friday @ 6:45pm-8pm Boys & Girls Ages 13-18 Friday @ 8pm-9:15pm Adult Music Program Classes Adult Vocal & Music Classes will begin Tuesday, September 19, 2023 @ 6:30pm Adult Instrument Classes Private Lessons Please advise when you are available for private lesson Adult Vocals Vocals Thursdays @ 7pm - 8pm Youth Music Program Classes Youth (Ages 6 - 19 only) Beginner Instrument Classes Dance (Beginner) - Wednesday 5:30pm - 6:30pm Drums 1 - Wednesday 5:30pm - 6:30pm Guitar 1 - Wednesday 5:30pm - 6:30pm Piano 1 - Wednesday 5:30pm - 6:30pm Vocals 1 - Wednesday 5:30pm - 6:30pm Youth Music Program Classes Select Youth Friday Classes (Ages 6 - 19 only) Drums 1 - Friday 5:00pm - 6:00pm Guitar 1 - Friday 5:00pm - 6:00pm Piano 1 - Friday 5:00pm - 6:00pm Select Youth (Ages 6 - 19 only) Beginner Instrument Classes Private Lessons - by Appointment Only Drums 1 - Saturday 9:30am - 10:30am Drums 1 - Saturday 11:30am - 12:30pm Guitar 1 - Saturday 9:30am - 10:30am Guitar 1 - Saturday 11:30am - 12:30pm Piano 1 - Saturday 9:30am - 10:30am Piano 1 - Saturday 11:30am - 12:30pm Early Childhood Classes (Ages 2-5) Early Childhood Music (Ages 4 & 5) - Saturday 10:30am - 11:30am Without Parents Toddler Dance (Ages 2-5) - Saturday - 10:30am - 11:30am Toddler Dance (Ages 2-5) - Friday - 12:30pm - 1:30pm Select Youth (Ages 6-19 only ) Performance Classes Vocals 1 - Saturdays 12:30pm - 1:30pm Theater 1 (NEW!) - Saturdays 11:30pm - 1:00pm Dance (Ages 12+) - Saturdays 10:30am - 11:30am Dance (Ages 6-11) - Saturdays 9:30am - 10:30am Select Youth (Ages 6-19 only ) Advanced Instrument Classes Drums 2 - Saturdays 10:30am - 11:30am Guitar 2 - Saturdays 10:30am - 11:30am Piano 2 - Saturdays 10:30am - 11:30am Junior Band (Invitation Only) Renaissance Band (Invitation Only) Tutoring Free tutoring will be available for registered students in grades 1 - 12 on Saturdays between the hours of 11:30am-1:30pm Registered Student Tutoring ONLY $ 25 per cycle (non-refundable) SAT / ACT Prep Registered Student Non-Registered Student Student Information Student Name * First Name Last Name Was the student enrolled in a Renaissance program in the past?: * Yes No If "Yes", please select any statements that are true of your experience at Renaissance: The Student looks forward to coming to class. The Student does not look forward to coming to class. The staff is professional. The staff is not professional. The service is affordable. The service is not affordable. I would recommend Renaissance programs and services to others. I would not recommend Renaissance EMS programs and services to others. The experience has positively impacted the development of the enrolled student. The experience has negatively impacted the development of the enrolled student. Gender * Male Female Date of Birth * Age (years) * 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Adult 25+ Name of School Does your school offer music? Yes No If yes then what type of programs: Band Chorus Orchestra Basketball Football Baseball Other If other please describe: Contact Information Parent Name * First Name Last Name Address * City * Zip Code * Home Phone * Cell Phone Email * Emergency Contact Information Emergency Contact Name First Name Last Name Relationship * Home Phone * Cell Phone Are there any medical conditions that should be brought to our attention? * Yes No If yes, please explain: Other Information Household Recipient Of: (Check All That Apply) * Public Assistance Medicaid Food Stamps SSI None Household Information Single Parent Both Parents Legal Guardian (adoption, foster parent) Extended Family Guardianship Other Ethinicity (Check All That Apply) * Latino African American Caucasian Native American Other Income Status 5k - 10k 10k - 15k 15k - 20k 20k - 25k 25k - 30k 30k - 35k 35k - 40k 40k - 45k 45k - 50k 50k & Up Membership Support Option If you are affiliated with a company or organization that can support our mission, please list your name, affiliation, and best method of contact. For school aged students, the most recent report card should be submitted. Please bring or mail in the report card to the center. Submit Application NOTE: If the form does not submit and redirect you to a Thank You message, please make sure you have completed all required fields. Items marked with * are required. Should be Empty: