The New York Workers Circle School 2024–2025 Brooklyn Registration

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Contact Information

First Name Last Name

Street Address

Postal Code City State

Email Home Phone (Optional)

Yes, sign me up for email updates.

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(Optional)

Ticket & Guest Information

Tuition fees include $100 Workers Circle Annual Membership.

Ticket Level		Quantity
Circle Playtime (3 months - 4 years) ($600)		`Number of Circle Playtime (3 months - 4 years) tickets ($600 each)`
First Child (5 years - 13 years) ($1,400)		`Number of First Child (5 years - 13 years) tickets ($1,400 each)`
Sibling (if both children are 5 - 13 years ($1,200)		`Number of Sibling (if both children are 5 - 13 years tickets ($1,200 each)`
Sibling (3 months - 4 years) ($550)		`Number of Sibling (3 months - 4 years) tickets ($550 each)`
The New York Workers Circle School Brooklyn Scholarship Fund (Optional)
TOTAL: $0		QTY: 0

Families can pay via payment plan, please email Madeline Solomon at msolomon@circle.org if you are interested

Please complete all relevant questions below:

Name and pronouns of Student 1:

Birthday of Student 1

School grade Student 1 will enter in 2024-25

Please let us know about any allergies:

Name and pronouns of Student 2: (Optional)

Birthday of Student 2 (Optional)

School grade Student 2 will enter in 2024-25 (Optional)

Please tell us about your child's needs, abilities, and experience: (Optional)

Please let us know about any allergies: (Optional)

Name and pronouns of Student 3 (Optional)

Birthday of Student 3 (Optional)

Please let us know about any allergies: (Optional)

Please tell us about your child's needs, abilities, experience:

Name and pronouns of Parent 1 (person completing this form)

Address of Parent 1 including zip code

Add this email address to shule parents Google group for weekly updates on classes and events (required for at least one parent)?

Add this email address to optional discussion group for current and alumni parents, teachers and community members?

Cell phone for Parent 1

Home phone for Parent 1 (Optional)

Occupation of Parent 1

Name and pronouns of Parent 2 (if applicable) (Optional)

Address for Parent 2 (if different from Parent 1) (Optional)

Email for Parent 2 (Optional)

Add this email address to optional discussion group for current and alumni parents, teachers and community members? (Optional)

Cell phone for Parent 2 (Optional)

Home phone for Parent 2 (Optional)

Occupation of parent 2 (Optional)

Name and cell phone # for emergency contact, if parent cannot be reached

How did you hear about us?

I grant permission to NYWCS to take photos and to make audio or video recordings of me and/or my child(ren), without identifying information, for the promotion, public education, and/or fundraising activities of the Workers Circle.

Add this email address to shule parents Google group for weekly updates on classes and events (required for at least one parent)?