ArtistWithin SUMMER Class Registration ONCE A WEEK

Summer 2023 Registration Form

May 30th - August 25th 2023
Registration*

New StudentReturning Student
Student Name*

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

MonthDayYear
Name of School Attending
Elementary, Middle or High School
Parent's/Customer Name*

PrefixFirst NameLast Name
Primary Contact Number*

Area CodePhone Number
Secondary Contact Number

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

First NameLast Name
Emergency Contact Number

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

Tuesdays 3:30 - 5:30 PMWednesdays 3:30 - 5:30 PMThursdays 3:30- 5:30 PMSaturday 11:00 AM - 1:00 PM
Choose Start Date*

MonthDayYear
How did you hear about The Artist Within School of Art?

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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*

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Today's Date*

My Products

Registration Fee $35.00

Required for First Time Students

Summer Supply Fee $25.00

Required For Each Semester

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 2023 Registration Form