Globe UC Songwriting

GLOBE Upper Campus Registration

Spring 2023 Songwriting Enrichment Class
Child Information
Child's Name *

First Name Last Name
Birth Date

Month Day Year
Homeroom Teacher *
Carpool Number *
Grade *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Release to *

Aftercare Pick-up
Parent/Guardian Information
Name *

First Name Last Name
Phone Number *
E-mail *
Emergency Information
Emergency Contact's Name *

First Name Last Name
Contact Number *
Relationship
Media Consent

With your permission A Time to Create, llc would love to display pictures and videos of your child’s creative songs, art work and some of the fun activities on the A Time to Create sites.

I hereby give permission for images of my child, captured during the A Time To Create, LLC after school songwriting enrichment class through sound, video, photo and digital camera, to be used solely for the purposes of A Time to Create websites, promotional material and publications, and waive any rights of compensation or ownership thereto.
Please select Accept if you agree with the media consent. Select Decline if you decline. *

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Songwriting Enrichment Class Globe Academy $ 300.00

Full payment option

Songwriting Enrichment Class Globe Academy (Half Payment) $ 155.00

Half payment option: Pay half now and you'll receive an invoice of $155 to complete payment. Due to processing fees the total payment for this option is $310.

Sponsor another student for the AT2C Songwriting Class $ 20.00

Your monetary gift will be added to a scholarship fund to assist students in need participate in the afterschool songwriting enrichment class. Thank you : )

Quantity

Songwriting App For Kids Fundraiser $ 10.00

The Songwriting App provides children with a safe place to express themselves, while providing parents with a tool useful to assist a child's emotional needs. Your support will help bring this app to life and help children nationwide.

Quantity

Total $ 0.00

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GLOBE Upper Campus Registration