Winter Programs Registration Form

Winter Programs Registration Form
Student Name*

First NameMiddle NameLast Name
Date of birth*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Gaurdian's Full name (if applicable)
Parent/Gaurdian's Full name (if applicable)
parent/student (18+) primary email*
Mobile Number*

Area CodePhone Number
Phone Number

Area CodePhone Number
Please list and explain Allergies and any other medical needs.*
Emergency Contact, full name and phone number*
*

Comics, Illustration & Publication - Ages 8-13 - Mon - 5:00-6:30PM
Please indicate which term *

Spring term: April - June (10 sessions)
Do you grant ArtCave permission to photograph*

the participant at workthe participant's artworkno photographs
All payments are due no later than 2 weeks after competition of this form and prior to start of each term. Spots are not guaranteed without payment.*

Pay by e-transfer to info@art-cave.caPay cash in personPay by cheque in person
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