Spring 2025 Enrichment Class Registration Form

Creative Writing - ENROLLMENT CLOSED

Crafts & Nature Play - ENROLLMENT CLOSED

Books & Baking - ENROLLMENT CLOSED

Stop-Motion Movie Making - ENROLLMENT CLOSED

Crocheting, Grades 4th-7th (Ages 9-13)

Register up to three students at one time.

Rows	First Name	Last Name	Birth Date
Student 1
Student 2
Student 3

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

Alt. Phone Number

Format: (000) 000-0000.

Second Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Format: (000) 000-0000.

Alt. Phone Number

Format: (000) 000-0000.

Do any of the students have any allergies, chronic illness, or medical conditions? If yes, please list their names and describe.*

Are any of the student prescribed an inhaler? If yes, please list their names and explain any instructions.*

Do any of the children have a developmental delay or diagnosis of which we need to be aware? If so, do they need any accommodations in the classroom?*

Select your preferred payment method. If credit card, we'll email you an invoice to pay. If Zelle, we'll send a payment request via Zelle from Creation Acre, LLC.*

Zelle Users: Please enter the name, email address, and/or phone number associated with your Zelle account.

How did you hear about us?*

How did you hear about us? (Other)

Cancellation Policy

All enrichment class fees are non-refundable. If a cancellation happens on our end at any point, you will receive a 100% refund, including any processing fees.

Date

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Spring 2025 Enrichment Classes

Student Information