ArtsCamp 2020 Registration Form

Art Class Registration Form

LiveArts Studio! Where the arts come alive!!!
Participant's Name 1: *

First Name Last Name
Day Class

Each Wednesday 10:00a to 11:00a March 9, to May 25, 2022
Evening Class

Each Wednesday 5:00pm to 6:00pm March 9 to May 25, 2022
Participant's Name 2: *

First Name Last Name
Youth Class

Each Wednesday 10:00a to 11:00a March 9, to May 25, 2022
Adult Class

Each Wednesday 5:00pm to 6:00pm March 9 to May 25, 2022
Home Phone Number: *

Area Code Phone Number
Mobile Number: *

Area Code Phone Number
Email Address: *
Primary Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please provide any medical, allergy restrictions here:
How did you hear about LiveArts Studio?: *
Emergency Contact Information
Emergency Contact Name:

First Name Last Name
Emergency Contact Phone Number:

Area Code Phone Number

Payment *

Art Class $ 125.00

Registration

Quantity
Item subtotal: $ 0.00

Credit Card

Should be Empty:

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