HARRISBURG ArtReach
Fall 2024 Registration Form
Student Name
*
First Name
Last Name
Grade Level
*
K5
1
2
3
4
5
6
7
8
9
10
11
12
Student ID
*
az123456
Academic Adviser
*
Email
*
Please use email most frequently used
Telephone Number (most used)
*
example: 123-234-3456
Telephone Number (secondary)
example: 123-234-3456
List All Adults (First & Last Name) That Have Permission To Pick Up The Student
*
Allergies:
leave blank if none
The Harrisburg Regional Office has a school nurse on staff. Are there any health conditions we should be aware of while the student is attending ArtReach?
leave blank if none
MONDAYS
*
9:00am to 10:15am (3rd-5th) Puppet Patterns
9:00am to 10:15am (K-2nd) Boomwhacker Band
10:30am to 11:45am (K-2nd) Creative Tales
10:30am to 11:45am (3rd-5th) Strings
12:15pm to 1:45pm (6th-8th) Edible Art
12:15pm to 1:45pm (9th-12th) Keys and Strings
2:00pm to 3:30pm (9th-12th) Art Journaling
2:00pm to 3:30pm (6th-8th) Theme Songs & Jingles
Submit Form
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