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Student Details

First Name

Last Name

Date of Birth

Age at Program Start

Parent/Guardian Details

First Name

Last Name

Relationship to Student

Phone number

Email address

Mailing Address

City

State

Zip code

Emergency Contact

First Name

Last Name

Relationship to Student

Phone Number

Medical Information

Does your child have any allergies or medical conditions we should be aware of?

No Yes

If yes, explain:

Will your child require any medication during the program hours?

No Yes

If yes, explain:

Primary Care Physician Name

Physician Phone Number

Acknowledgments & Consent

I understand that this is a training and enrichment program and that my child is expected to participate respectfully and safely.

I acknowledge that all tuition and fees are non-refundable after the deadlines outlined in the official cancellation policy.

I understand that my child must be picked up promptly at the end of each session.

I give my child permission to participate in all program-related activities.

I have read and agree to all program policies as outlined in the Parent & Student Handbook.

Digital Signature Authorization & Disclaimer

By typing my full legal name below and submitting this application, I understand and agree that this electronic signature is the legal equivalent of my handwritten signature. I affirm that I am the parent or legal guardian of the student named above, that all information provided is true and complete to the best of my knowledge, and that I have read, understood, and agreed to the policies and requirements of FutureStar Studios and The MusicSquared Foundation, Inc. I acknowledge that if the student is accepted into the program, a $500 non-refundable deposit is required to secure their spot. I understand that this deposit is applied toward the total tuition and that it is non-refundable under any circumstances unless the program is canceled by FutureStar Studios. I further understand that this digital signature is legally binding and enforceable under federal and New York State law, including the Electronic Signatures in Global and National Commerce (E-SIGN) Act.

Full Legal Name

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Student Details

Parent/Guardian Details

Emergency Contact

Medical Information

Acknowledgments & Consent

Digital Signature Authorization & Disclaimer

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