Plotline Fall 2025 Tween Registration

Student's Full Name*

First NameLast Name

Student's Birth Date

Date

Parent/Guardian Full Name*

First NameLast Name

Your Phone Number - Also used for Class Text Updates*

Format: (000) 000-0000.

YesNo

Name

First NameLast Name

2nd Phone Number for Class Text Message Updates

Please enter a valid phone number.Format: (000) 000-0000.

E-mail*

example@example.com

Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code

TextE-mailPhone Call

Yes

Any allergies, health restrictions or learning challenges we should know of? *

List two emergency contacts for the Student:*

YesNo

How did you hear about Plotline & this program?

Pay by Debit or Credit CardPay by Check

Please make check payable to Plotline.

Include Full Tuition $380 or the first of four installment payments of $95.

Bring payment to class or send to:

Plotline

411 N Sherman Pkwy

Springfield, MO

65802

Tuition Options*

Full Tuition

Pay Full Tuition Now

$380.00

Installment Payments

$97 due now. You'll be invoiced $97 for the next three months for the remainder.

$97.00

Total

$0.00