CE Summer Workshops Pre-Registration

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The Office of Continuing & Professional Development
Kingston Center of SUNY Ulster
94 Mary's Avenue
Kingston, NY 12401
cereg@sunyulster.edu | 845-339-2025

SUNY Ulster Summer Workshops - Pre-Registration Form

Child's First Name:

Child's Last Name:

Gender

Date of Birth

Current Age

Parent/Guardian Completing this Form

Parent First Name:

Parent Last Name:

Address:

City:

State:

Zip:

Parent Phone Number:

Parent Email Address:

Second Parent/Guardian

Parent First Name:

Parent Last Name:

Parent Phone Number:

Parent Email Address:

Emergency Contact Information

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Phone Number:

Emergency Email Address:

Health & Medical Information

Please list any medical conditions your child has, including a recent/current illness or injury, existing medical condition, restriction or limitations, seizure disorders, asthma, allergies (i.e. medications, food, insect stings, etc.) or special needs. Also list any medication taken by the student at home or during the program hours.

Please inform us of any medications your child is carrying on to campus - i.e. EPI-Pen, Insulin, Pills, etc.

Please review our SUNY Ulster Policies

SUNY Ulster may cancel any workshop that lacks sufficient enrollment up to one week before the start date. If cancelled, a notice and full refund will be issued. Full refunds are issued up to two weeks prior to class. Please allow, 3-4 weeks for a refund.
If you choose to cancel your child’s enrollment two weeks or less prior to the start date, you will be charged a prorated administrative fee of 25% of the cost of class (not to exceed $50).
No refunds will be granted on or after the start date of class.
Please do NOT drop off and pick up your child without ensuring your child is signed in/out by the instructor.
Your child may be suspended or terminated from any workshops, at the discretion of the director, for inappropriate language or behavioral problems that endanger other people or create an unfavorable atmosphere for the rest of the group.
SUNY Ulster has the right to change an instructor without notification.
SUNY Ulster is not responsible for lost belongings. Items will be held for one week after the workshop has ended. Be sure to label your child's possessions. Lost items will be given to Public Safety & Security (845-687-5023) at the completion of each workshop and held there for one week.
SUNY Ulster complies with all Ulster County Health Department regulations

Following the submission of this form you will receive an email with links to register and pay for the course. The student is NOT registered until the course is paid for.

By submitting this form you acknowledge that you have read and understand all of the policies and procedures for this program.

Form owner: SUNY Continuing Education | If there are any issues or errors, please contact: cereg@sunyulster.edu

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