HSAD K-12th Grade SUMMER Class Registration ONCE A WEEK

K-12th Grade Registration Form

SUMMER 2024
Registration*

New StudentReturning Student
Student Name*

First NameLast Name
Age
Date of Birth

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

PrefixFirst NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Number*

Area CodePhone Number
Secondary Contact Number

Area CodePhone Number
E-mail*
Emergency Contact

First NameLast Name
Emergency Contact Number

Area CodePhone Number
Choose Class Day/Time

Mondays 3:30 - 5:30 PMTuesdays 3:30/4:30 - 5:30 PM (Flex start time)Wednesdays 3:30 - 5:30 PMThursdays 3:30 - 5:30 PMFridays 3:30 - 5:30 PMSaturday 10 AM - 12 PM (class full call to be waitlisted)Saturday 1 - 3 PM
Choose Start Date*

MonthDayYear
You may select a date in middle of month it will be 4 classes consecutively after that

My Products

Registration Fee $35.00

Required for First Time Students

Summer Semester Supply Fee $25.00

Required For Each Semester

K-12th Grade Class Monthly Tuition$160.00

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

Summer Semester$450.00

(June - August) Once a Week Classes Savings of $30

Enter coupon

Total $0.00

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Please list any diagnosed medical conditions the school needs to be aware of
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*
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K-12th Grade Registration Form