Art/Spanish Registration Form

Student 1*

First NameLast Name

Student 1 Birth Date*

MonthDayYear

Student 2

First NameLast Name

Student 2 Birth Date

MonthDayYear

Parent/Guardian*

First NameLast Name

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

Area CodePhone Number

E-mail*

Parent/Guardian 2*

First NameLast Name

Address, if different:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

Area CodePhone Number

E-mail*

Name*

First NameLast Name

Relationship to Child*

Phone Number*

Area CodePhone Number

Full Name

First NameLast Name

How did you hear about Art For Life?*

If your child has prior Art/Spanish/ Sewing experience (number of years, technique, studios, etc.), please describe below

Choose your selection*

Mondays Art & Spanish: 5:00- 6:00 pm, 5-8 years oldTuesdays Art: 4:30- 5:30 pm, 5-8 Years oldTuesdays Art: 4:45-6:45 pm, 5-8 Years oldWednesdays Art: 5:00 - 6:30 pm, 9-11 Years oldWednesdays Art: 6:45 - 8:15 pm, 9-11 Years OldThursdays Art 5:00-6:30 pm, 13-16 Years OldThursdays Art 6:45-8:15 pm, 10-12 Years OldPrivate one-on-one classSaturdays Sewing/ Fashion:10:00 -11:30 am, 8 Years Old +

TUITION AND FEES: By signing this document, I understand that tuition is due by the first class of each month, and could be $100, $125, $150, $165, or $260 depending on your child's plan. A $10 late fee will be charged if paid after 5 days of your due date or $15 after the 10th day of your due date. Tuition is charged by the first five days of each month, or your start date, no matter how many classes my child attends. I understand that there is an annual (9-month program) materials fee of $65 for Art, Spanish, Sewing and any other afterschool class. All classes are allowed two inclement weather cancellations, which will not be required to make up.

PHOTO/VIDEO RELEASE: Art For Life In Buford! includes photos of students, teachers, and studio activities on our website and printed materials. I understand that these pictures will be accessible to anyone with internet access. I give my permission for Art & Spanish For Life! or Art for Life to use photos of my child/children on its website, on Facebook, in printed materials, and electronic forms of communication. I understand that if I do not want images of my child to be used, I will indicate this by marking the choice below in this document.

DECLARATION: By electronically signing below, I confirm that I have read the document in its entirety. I understand the document, have had an opportunity to ask questions, and agree to be bound by its terms.

Media release: *

Grant PermissionDeny Permission

I AGREE to all terms listed above, by electronically signing here:*

Date/Time Verification

MonthDayYearHourMinutesAM/PM Option

Enter the message as it's shown*

Art for Life! Afterschool Program

Family Information

Emergency Contact - Please do NOT list the family contact from the previous section.

Person Authorized to Pick-Up Child

Art/Spanish

Class Selection

Tuition, Fees, and photo/video Release