Art Lessons Enrollment Form 12-18 THURSDAYS

Art Lessons Registration: 12-18 yo

Instructor: Bracken Hermansen 2104 Rhonda Terr Henderson 89074 702.468.1057 brackenrae@gmail.com
Student Name *

First Name Last Name
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name *

First Name Last Name
Cell Number *

Area Code Phone Number
E-mail *
1 Hour Class selection
12-18 Yr olds *

THURSDAYS 3pm
Please pay via Venmo (@Bracken-Hermansen) for the month, at the beginning of the month.

September- $90

(Dates 10/17/24)

October- $120

(Dates 1/8/15/22)

November- $90

(Dates 5/12/19)

Dec- $90

(Dates 3/10/17)
Should be Empty:

Art Lessons Registration: 12-18 yo