Youth Program Forms and General Information
All students will be asked to review and accept our Terms and Conditions.
In addition, the following forms are required before the Summer Youth Academy program starts in June. Forms will be submitted through the applicant portal during the enrollment process.
Once the enrollment form is filled out, you will receive a student portal login and password by email. You may register your student for workshops and classes in the student portal. If you have any issues during enrollment, contact Lyme Academy’s Director of Academic Affairs at caitlin@lymeacademy.edu or call 860-434-5232, ext 202.
Summer Youth Academy Required Forms
- Enrollment Form*
- Medical Exam Form from a physician from the previous 36 months* (see example)
- Immunization Record*
- Medication Administration Record (MAR) and Authorization Form (only if applicable)
- Individual Plan of Care Form (only if applicable): Anaphylaxis and Asthma, Seisure Action Plan, and Hypoglycemia Action Plan
* Required
Instructions for Registering for Summer Youth Workshops in the Student Portal
Learn more
Contact Information
Lyme Academy of Fine Arts
Youth Academy
84 Lyme Street
Old Lyme, CT 06371
Phone: 860.434.5232
Rick Lacey, Facilities Co-Manager and Youth Academy Director
rick@lymeacademy.edu
Marissa Assal, Instructor and Alternate Youth Academy Director
marissaasalart@gmail.com
Caitlin Perkins, Director of Academic Affairs
caitlin@lymeacademy.edu
