Art/Spanish Registration Form

Student 1 *

First Name Last Name

Student 1 Birth Date *

Month Day Year

Student 2

First Name Last Name

Student 2 Birth Date

Month Day Year

Parent/Guardian *

First Name Last Name

Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Home Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

E-mail

Parent/Guardian 2

First Name Last Name

Address, if different:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Home Phone Number

Area Code Phone Number

Cell Phone Number

Area Code Phone Number

E-mail

Name *

First Name Last Name

Relationship to Child *

Phone Number *

Area Code Phone Number

Full Name

First Name Last Name

How did you hear about Art & Spanish For Life? *

Friend or Family Facebook Website Flyer Other

If your child have experience, please list prior art experience (number of years, technique, studios, etc.)

Choose your selection

Mondays Art & Spanish at the studio: 4:30– 5:30 pm. 5-8/ 5:40-6;40 pm 5-8 years old. Tuesdays Art at the studio: 4:30 – 5:30 pm. 5-8 years old. Tuesdays Art at the Studio: 5:40- 6:40 pm . 5-8 years old. Wednesdays Art at the studio: 5:00-6:30 / 6:50- 8:20PM 9-12 Years old Thursdays Art at the studio: 5:00 - 6:30 pm 13-16 Years old

TUITION AND FEES: By signing this document, I understand that tuition is due by the first class of each month, is $80/100 and that a $10 late fee will be charged if paid after the 5th or $15 after the 10th. Tuition is charged by the first three days of each month, no matter how many classes my child attends. I understand that there is an annual registration fee of $45 for Art / $35 for Spanish. All classes are allowed two inclement weather cancellations which will not be required to make up.

PHOTO/video RELEASE: Art & Spanish For Life! and Art for Life are including photos of students, teachers, and studio activities on its 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 in 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 to 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 Permission Deny Permission

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

Date/Time Verification

Month Day Year Hour Minutes AM/PM Option

Enter the message as it's shown *

Art for Life!/ Art & Spanish for Life!

Family Information

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

Person Authorized to Pick-Up Child

Art/Spanish History

Class Selection

Tuition, Fees, and photo/video Release