Youth FX Summer Registration Form

DATE:  Monday, July 9th - Friday, August 10

TIME: 10am-4pm 

LOCATION: Youth FX Studio

25 Warren St. Albany, N.Y. 12202

(btwn. Phillip & Grand St.)

Albany, NY 12202

If you have any questions, please contact us at: info@youthfx.org

Student Name *
Student Name
Phone *
Phone
Please provide a phone number that we can reach you at throughout the summer and afterwards.
SOCIAL MEDIA
We will be posting regularly on social media throughout the 5 Weeks of Youth FX. Please share any social media you have below to be tagged in our posts.
HEALTH | WELLNESS
Although we will not be serving lunch on site, we will be offering snacks and would like to be aware of any allergies to lower the risk of an allergic reaction.
PARENTAL INFORMATION
Parent Name *
Parent Name
Phone *
Phone
Address *
Address
EMERGENCY CONTACT
Please list an emergency contact that is not your parent.
Emergency Contact *
Emergency Contact
Emergency Phone *
Emergency Phone