After School Art Program 2026-2027
Student Name
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Middle Name
Last Name
Age
School
Teacher
Address
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Street Address Line 2
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Additional Comments, Concerns, Special needs: (physical; developmental; behavioral/emotional; sensory). This information helps our staff to do their best to accommodate all of our students particular needs.
Authorization for Medical Treatment: in the event that parents/guardians named on this form cannot be reached, I authorize officials of the Blue Giraffe Education Center to consent on my behalf, to provide emergency treatment for my child
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Parent Name
First Name
Middle Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
Emergency Contact #1
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First Name
Last Name
Phone Number
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Area Code
Phone Number
Emergency Contact #2
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First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Monday Fall Session 3:30-5:00pm 9 classes: August 1, September 14, 21, 28, October 5, 19, 26, November 9, 16, 23 $660
Monday Evening Winter Session 5:00-6:30pm 9 classes: December 1, 8, 15, January 5, 12, February 2, 9, 23, March 2 $495
Monday Evening Spring Session 5:00-6:30pm 12 classes: March 9, 16, 23, 30, April 20, 27 May 4, 11, 18, June 1, 8, 15 $660
Tuesday Winter Session: 3:30 - 5:00 pm 12 classes: December 2, 9, 16, January 6, 13, 20, 27 February 3, 10, 17, 24 March 3 $660
Tuesday Spring Session: 3:30 - 5:00 pm March 10, 17, 24, 31, April 7, 21, 28, May 5, 12, 19, 26, June 2, 9 13 classes $715
Tuesday Evening Fall Session: 5:00 - 6:30pm 12 classes: September 2, 9, 16, 23, 30, October 7, 14, 21, 28, November 4, 18, 25 $660
Tuesday Evening Spring Session: 5:00 - 6:30 pm March 10, 17, 24, 31, April 7, 21, 28, May 5, 12, 19, 26, June 2, 9 13 classes $715
Wednesday Winter Session: 3:30 - 5:00 pm 12 classes: December 3, 10, 17, January 7, 14, 21, 28 February 4, 11, 18, 25 March 4 $660
Wednesday Spring Session: 3:30 - 5:00 pm March 11, 18, 25, April 1, 8, 22, 29, May 6, 13, 20, 27, June 3, 10 13 classes $715
Wednesday Evening Winter Session: 5:00 - 6:30 pm 12 classes: December 3, 10, 17, January 7, 14, 21, 28 February 4, 11, 18, 25 March 4 $660
Wednesday Evening Spring Session: 5:00 - 6:30 pm March 11, 18, 25, April 1, 8, 22, 29, May 6, 13, 20, 27, June 3, 10 13 classes $715
Thursday Spring Session: 3:30 - 5:00 pm March 12, 19, 26, April 2, 9, 23, 30, May 7, 14, 21, 28, June 4, 11 13 classes $715
Thursday Evening Spring Session: 5:00 - 6:30 pm March 12, 19, 26, April 2, 9, 23, 30, May 7, 14, 21, 28, June 4, 11 13 classes $715
Saturday Morning Winter Session at 11:30-1:00 pm 12 classes: December 6, 13, January 3, 10, 17, 24, 31 February 7, 14, 21, 28 March 7 $660
Saturday Morning Spring Session at 11:30-1:00 pm 12 classes: March 14, 21, 28, April 4, 25, May 2, 9, 16, 23, 30 June 6,13 $660
Saturday Afternoon Spring Session at 1-2:30 pm 12 classes: March 14, 21, 28, April 4, 25, May 2, 9, 16, 23, 30 June 6,13 $660
Saturday Afternoon II Spring Session at 2:30-4:00 pm 12 classes: March 14, 21, 28, April 4, 25, May 2, 9, 16, 23, 30 June 6,13 $660
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Pick Up From Janney ES
$180.00
$
180.00
Tuesday, Wednesday, Thursday 13 classes
$715.00
$
715.00
13 classes
Tuesday, Wednesday, Thursday 10% Off Second Child
$643.50
$
643.50
13 classes session
Monday, Saturday 12 classes
$660.00
$
660.00
12 classes
Monday, Saturday 10% Off Second Child 12 classes
$594.00
$
594.00
12 classes
Total
$0.00
$
0.00
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