ArtistWithin SUMMER Class Registration ONCE A WEEK

Summer 2021 Registration Form
Registration *

New Student Returning Student
Student Name *

First Name Last Name
Age
"A" for Adults
Date of Birth

Month Day Year
Name of School Attending
Elementary, Middle or High School
Parent's/Customer Name *

Prefix First Name Last Name
Primary Contact Number *

Area Code Phone Number
Secondary Contact Number

Area Code Phone Number
E-mail *
Invoices and other school updates/notices are sent to email on file
Emergency Contact

First Name Last Name
Emergency Contact Number

Area Code Phone Number
Please list any allergies or medical conditions the school needs to be aware of
Art Summer School - Once A Week 2 Hours

Mondays 3 - 5 PM Tuesdays 3 - 5 PM Saturday 10 AM - 12 PM Saturday 1 - 3 PM Wednesday 3 - 5 PM
Choose Start Date *

Month Day Year
How did you hear about The Artist Within School of Art?

Driving By Ad Friend YELP Google Facebook
Additional Notes
I give my permission for my child's photo and artwork to be used in promotional material. Only first name, last initial and age will be used for credit line.
Parent's Signature *

Clear
Today's Date *

My Products

Registration Fee $ 35.00

Required for First Time Students

Supply Fee $ 25.00

Required For Each Semester

Supply Fee Options

Class Monthly Tuition $ 150.00

Once A Week Class (4 x two hour Art Lessons)

Summer Semester $ 420.00

(June - August) Once a week classes Savings of $30

Enter coupon

Total $ 0.00

Summer 2021 Registration Form