Clone of Music Therapy Registration Form

Lettering and Graffiti Workshop for Teens

At KYCC Recovery Services, by Javier "Wolf" Callejas
This is an registration form for 10-month Lettering and Graffiti Workshop for teens. Participants are not required to but highly recommended to attend all workshops.

Workshops are funded by LACDPH SAPC for teens and led by Javier "Wolf" Callejas.

Participants must register and answer all questions.

You must provide emergency contact in order to register. You will receive a phone call to confirm registration.

Sessions are at 3727 W. 6th St., Suite 411, Los Angeles, CA 90020

Saturdays from 1-3 PM

Please call (213) 365-7400 and ask for Recovery Services for questions.
My Name

First NameLast Name
Age
My Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I would like to participate on the following dates (please choose one or more):
Should be Empty:

Lettering and Graffiti Workshop for Teens