TRY-OUT CLASS Enrollment

TRY-OUT CLASS Enrollment

12671 S Dixie Hwy, Pinecrest 33156
Student Name*

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Student Date of Birth*

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Date
Student Age*
Home Address*

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Student Medical Notes
Allergies
Parent/Guardian Name*

First NameLast Name
Relation*
Phone Number*
Email Address*
Emergency Contact Name*

First NameLast Name
Relation*
Phone Number*
This is a non refundable service for first-time students. Priscilla & Tiffany’s Arthouse reserves the right of admission.Please note that Priscilla & Tiffany’s Arthouse and its instructors are not certified to work with or provide specialized instruction for students with disabilities. With your understanding of the facility of Priscilla & Tiffany’s Arthouse is not liable for any type of injury, to any one person that is in attendance due to materials or items sold. Priscilla & Tiffany’s Arthouse is not responsible for any missing, stolen, or lost items. By signing below you agree that Priscilla & Tiffany’s Arthouse is harmless from any suits, attorney’s fees, judgments, loss, claim, liability, damage, cost or expense demand whatsoever in law of equity (including those arising out of any appeals) which may be brought against Priscilla & Tiffany’s Arthouse now or in the future. You agree that in the event that medical attention is required due to an accident or illness, and your contact person is unreachable, Priscilla & Tiffany’s Arthouse shall be permitted to seek such medical services, as it shall deem necessary and appropriate through EMS/911 and/or local hospitals. You grant the Arthouse permission to photograph, videotape, or record the student during studio activities.

I have read and understood the aforementioned information and agree to comply with it.
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Date*

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My Products

Try Out Class (09/10 Wed. 3:30-4:30 PM) Ages 7-12Try out our watercolor explorers class, supplies included.

$45.00

Try Out Class (09/10 Wed. 5:30-6:30 PM) Ages 7-12Try out our art club class, supplies included.

$45.00

Try Out Class (09/10 Wed. 4:30-5:30 PM) Ages 7-12Try out our art club class, supplies included.

$45.00

Try Out Class (09/10 Wed. 6:30-7:30 PM) Ages 13-17Try out our art club class, supplies included.

$45.00

Try Out Class (09/11 Thurs. 3:30-4:30 PM) Ages 4.5-7Try out our mini art club class, supplies included.

$45.00

Try Out Class (09/11 Thurs. 4:45-5:45 PM) Ages 7-12Try out our art club class, supplies included.

$45.00

Try Out Class (09/11 Thurs. 6:00-7:00 PM) Ages 13-17Try out our art club class, supplies included.

$45.00

Try Out Class (09/13 Sat. 10-11am) Ages 4-6Try out our watercolor explorers class, supplies for session included

$45.00

Try Out Class (09/13 Sat. 11:30-12:30pm) Ages 7-12Try out our art club class, supplies included.

$45.00

Total

$0.00

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