Student Information:
Submitting this form does not guarantee a trial session for your child. CW will do our best to accommodate your request and will contact you to confirm. A minimum enrollment of 3 students needs to be met, or a class may not be offered. Trial classes are free. Only one trial class per child. If your child has attended any CW classes or programs they do not qualify for a trial class. $25/ class. Each semester has a total of 11 classes and $30 material fee that covers all classes. Questions? Contact: info@cw-arts.org or 626-445-6005.
Student 1 Name
*
First Name
Last Name
Age
Student Birthday
-
Month
-
Day
Year
Date
Date Picker Icon
Gender
Female
Male
Select Trial Class and Time:
*
Art 101 (ages 4-5) Saturday 10:30 am - 12:00 pm
Art 102 (ages 5-6) Saturday 10:30 am - 12:30 pm
Art 102 (ages 5-6) Saturday 1:30 pm - 3:30 pm
Art 103 (ages 7-9) Saturday 1:30 pm - 3:30 pm
Art 104 (ages 10-12) Saturday 1:30 pm - 3:30 pm
Select Trial Class Date:
*
4/27/19
5/4/19
5/11/19
Please list any Medical Conditions, Allergies, Prescribed Medicines, Learning or Behavioral Information:
Add another student?
*
Yes
No
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Student 2 Information:
Student 2 Name
First Name
Last Name
Age
Student Birthdate
-
Month
-
Day
Year
Date
Date Picker Icon
Gender
Female
Male
Select Trial Class and Time:
Art 101 (ages 4-5) Saturday 10:30 am - 12:00 pm
Art 102 (ages 5-6) Saturday 10:30 am - 12:30 pm
Art 102 (ages 5-6) Saturday 1:30 pm - 3:30 pm
Art 103 (ages 7-9) Saturday 1:30 pm - 3:30 pm
Art 104 (ages 10-12) Saturday 1:30 pm - 3:30 pm
Select Trial Class Date:
4/27/19
5/4/19
5/11/19
Please list any Medical Conditions, Allergies, Prescribed Medicines, or Behavioral Information:
Add another Student?
Yes
No
Back
Next
Student 3 Information:
Student 3 Name
First Name
Last Name
Age
Student Birthdate
-
Month
-
Day
Year
Date
Date Picker Icon
Gender
Female
Male
Select Trial Class and Time:
Art 101 (ages 4-5) Saturday 10:30 am - 12:00 pm
Art 102 (ages 5-6) Saturday 10:30 am - 12:30 pm
Art 102 (ages 5-6) Saturday 1:30 pm - 3:30 pm
Art 103 (ages 7-9) Saturday 1:30 pm - 3:30 pm
Art 104 (ages 10-12) Saturday 1:30 pm - 3:30 pm
Select Trial Class Date:
4/27/19
5/4/19
5/11/19
Please list any Medical Conditions, Allergies, Prescribed Medicines, or Behavioral Information:
Add another Student?
Yes
No
Back
Next
Student 4 Information:
Student 4 Name
First Name
Last Name
Grade
Student Birthdate
-
Month
-
Day
Year
Date
Date Picker Icon
Gender
Female
Male
Select Trial Class and Time:
Art 101 (ages 4-5) Saturday 10:30 am - 12:00 pm
Art 102 (ages 5-6) Saturday 10:30 am - 12:30 pm
Art 102 (ages 5-6) Saturday 1:30 pm - 3:30 pm
Art 103 (ages 7-9) Saturday 1:30 pm - 3:30 pm
Art 104 (ages 10-12) Saturday 1:30 pm - 3:30 pm
Select Trial Class Date:
4/27/19
5/4/19
5/11/19
Please list any Medical Conditions, Allergies, Prescribed Medicines, or Behavioral Information:
Back
Next
Parent / Legal Guardian Information
Parent / Legal Guardian Name
*
First Name
Last Name
Parent / Legal Guardian Phone Number
*
-
Area Code
Phone Number
Parent / Legal Guardian Email
*
example@example.com
POLICY AGREEMENT: I understand: enrollment is based on a first come first served basis. CW will contact 911 in the event of an emergency and if I cannot be reached. Neither CW nor its individual staff or volunteers shall be liable or responsible for any injury that may occur to the student at any time or any place during the program. I will be responsible for the medical fees for the above minor should s/he require emergency medical treatment while attending CW art program or art activities. Tuition is non-refundable once the registered sessions / classes begin. I am responsible for notifying the school of any absence at least one day in advance. CW allows ONLY 2 absent credits to be used toward the next sign-up session. I understand that my child must be picked up after class in a timely manner. If I do not pick up my child within 15 minutes of class ending CW will contact the alternative contact to request my child be picked up. I agree to pick up my child when requested due to health or behavioral issues.
I AGREE to the Policies stated above.
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