Anna Banana Registration

Student Information Form
Student Information

Please give us some information about the student.
Has the student attended an Anna Banana class or camp before?
Has any major information (cell phone, address, allergies, etc.) changed since then?
Student First Name
Last Name
Date of Birth: month/day/year
Gender
Grade in School
Parent Information
Parent First Name
Last Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
E-mail
Medical
Please list any medical issues/allergies.
Release/Right to use photos
By submitting this form, I agree to release Anna Banana Arts and Crafts, LLC and any employees of Anna Banana Arts and Crafts, LLC from any injury, illness or medical responsibility. I understand that should an emergency arise, Anna Banana Arts and Crafts, LLC will call 911 first and the parent second. I also give permission for Anna Banana Arts and Crafts to take and use photos of my child/children for promotional and social media purposes. I agree to the terms and cancellation policies of Anna Banana Arts and Crafts. *please review the cancellation policy before regisitering*
Please list emergency contact name(s) and phone number(s) here:
Emergency Contact info
Class Selection & Payment
2026

Fall Session 2 classes and camps- starts 10/27

Thanksgiving Break Camps Nov. 23, 24 & 25

Christmas Break Camps Dec. 21-23 and Dec. 28-30

Student Information Form