Summer Art + Design Supplemental Registration

Please fill out the supplemental registration information below and select submit.

Your Name (required)

Student's Name (required)

Your Email (required)

Emergency Contact Information (please list two contacts)

Emergency Contact Name (1)

Relationship

Day Phone

Cell Phone

Emergency Contact Name (2)

Relationship

Day Phone

Cell Phone

Medical Information

Is your child currently under treatment for any medical conditions?

Please list any disabilities (academic, physical, social/emotional), allergies or medical conditions:

My child is up to date on all required immunizations.

In case of emergency, I give my permission for The Sage Colleges to have my son/daughter treated at Albany Medical Center.

Parking Information

Will your child be driving him/herself to Sage?

If your child will be driving him/herself to Sage, please provide the following vehicle information for a parking pass.

Vehicle Make

Vehicle Model

Vehicle Year

License Plate #

License Plate State

Registered Owner Name

Registered Owner Address

My child has permission to leave campus during the lunch hour

Parking passes will be distributed on the first day of the Summer program. Please abide by all parking regulations.


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