Bright Art Studio Enrollment Form

Bright Art Studio Registration
CHILD INFORMATION:
Today’s Date

MonthDayYear
Date
Child’s Name*

First NameLast Name
Birth Date*

MonthDayYear
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Subscribe me to your email newsletter so I can know when new classes and workshops are being offered.
How did you hear about us?
EMERGENCY CONTACT
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship to Child*
MEDICAL INFORMATION
Allergies*
Medical Concerns
Any further comments or concerns?
Should be Empty:

Bright Art Studio Registration