Course Registration and Payment Form

R.I.S.E. Up - Registration Form

Fill out the form carefully for registration
Child's Name *

First Name Last Name
R.I.S.E. Up exists to foster creative writing and character in upper elementary school students (grades 3-6). By utilizing the arts (creative writing, poetry, and rap), we thrive on mentoring students to rise up in their academics as well as in their environments, in order to achieve on a higher level.

These six-week, 1:1 sessions focus on the four foundational principles of: Respect, Integrity, Self-Esteem, and Education.

Your child will be encouraged to imagine, create, think outside the box, and express him/herself.

“Children who practice creative writing are generally better in other subjects (such as science, math, and foreign languages) and they grow up happier because they are equipped with the right skills to deal effectively with life.”
Birth Date *

Month Day Year
Gender *
Address *

Street Address

Street Address Line 2

City State / Province
Parent E-mail *
Phone Number *

Area Code Phone Number
Additional Comments:
Course must be paid for in full. Duration of course is 6 weeks.
First Session/Appointment (you will be contacted to schedule your additional sessions.)

My Products

R.I.S.E. Up Arts Initiative $ 150.00

R.I.S.E. Up Arts Initiative: 6 sessions

Total $ 0.00

R.I.S.E. Up - Registration Form