Academy application 2024/5

Centauri Arts Academy Application

2024/25 Year.
Use this form to register a participant for our Virtual or In-Studio arts classes.

Once this form has been submitted, you will see a confirmation message on your screen and receive an email confirming the form has been received. Please complete a new form for each participant.
Date

MonthDayYear
Date
PARTICIPANT INFORMATION
Have you been to Centauri Before?*

YESNO
Full Name of Participant*

First NameLast Name
If your child goes by a different name other than their given name above, please specify here:
Date of Birth (if under 18)*
MM/DD/YYYY
Grade
Participant Cell Number (if they have one)
Participant Email
CONTACT INFORMATION
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number*
Family Email*
GUARDIAN CONTACT INFORMATION
(if participant is under 18)
Guardian 1 Full Name*

First NameLast Name
Relationship to Participant*
Guardian 1 Email*
Guardian 1 Cell Number*
Guardian 2 Full Name

First NameLast Name
Relationship to Participant
Guardian 2 Email
Guardian 2 Cell Number
REGISTER FOR THE FULL YEAR (Semester 1 and 2) BY SEPTEMBER 2023, AND RECEIVE THE FOLLOWING DISCOUNT ON SEMESTER 2:
In-studio arts classes (discount - $140)
Virtual Arts Classes (discount - $100)

If you choose the full year, a space is held in both semesters, but the second semester fee is not due until December. You will pay for semester 1 now and the discount will be applied to your invoice for semester 2.
Attendance*

Semester 2 Monday 27 January 2025 – mid May 2025
Please reserve me a space in the following 8 week STUDIO courses ($336+HST)

Fine Art: From Monet to Matisse , Ages 10-15 Monday 5.00pm - 6.30pm) STARTS Jan 6
Please reserve me a space in the following 14 week STUDIO course(s) ($620+HST)

Digital Art, Ages 12-17 (Monday, 7pm to 8.30pm)Creative Writing Salon, Ages 9-13 (Tuesday 5.00pm - 6.30pm)An Actor’s Workshop, Ages 11-17 (Tuesday 7.00pm - 8.30pm)Fine Art Explorations, Ages 11-17 (Wednesday 5.00pm - 6.30pm)Fabric Arts, Ages 11-17 (Wednesday 7.00pm - 8.30pm)Film Production, Ages 11-17 (Thursday 5.00pm - 6.30pm)Film Production, Ages11-17 (Thursday 7.00pm - 8.30pm)Creative Writing Salon,Ages 12-17 (Saturday 11-15am-12.45pm)
Please reserve me a space in the following 14 week VIRTUAL course(s) ($400+HST)

Digital Art, Virtual Ages 12-17 (Monday, 7pm to 8.30pm)Creative Writing Salon, Virtual, Ages 11-17 (Wednesday, 7pm to 8.30pm)
Please add me to the waiting list for the following full courses:

Creative Writing Salon, Ages12-18 (Saturday 11.00am - 12.30)Film Production, Ages11-17 (Thursday 7.30pm - 9.00pm)Fine Art Fiesta, Ages 11-16 (Wednesday 5.00pm - 6.30pm)Creative Writing Salon (Wednesday, 7pm to 8.30pm)
number studio
Studio Classes
studio discount
number virtual
Virtual Classes
virtual discount
Promo Code
Discount
Semester 1 before discount
Total (semester 1 & 2 fees)
Semester 2 Total
HST (13% tax)
Semester 2 Grand Total
Pay Plan
Centauri Arts incurs a fee for payments made by credit card and we have chosen not to pass this on to you. If you can consider payment by Interac e-transfer this is always appreciated. Thank you!
Payment Method*

I will send an Interac e-transfer payment for the full amount (preferred)I will pay online now by credit card/paypal. (you will be redirected to a payment site after the form is submitted)I will call with a credit card
Payment
prevnext( X )
Payment Plan(CAD for each month)
3 equal payments. One payment now and 2 payments each month after .

Full Payment(CAD for each month)
Full payment now for semester 2

Total $0.00CAD
Where did you find out about Centauri Arts Academy*

Web Search - Google/BingReferral from a family memberReferral from a friend (please give the name in the comments)InstagramFacebookSaw our sign in Bloor West VillageNewspaper/MagazineOther
Comments
Please note any medical/allergy concerns (e.g. recent fractures etc)
I authorize my son/daughter to leave at the end of the course(s) unescorted (for in studio courses only) *
Please write the names of all adults authorized to collect the participant at the end of the course
Please read:
Virtual class code of conduct for participants

In Studio & Virtual Class booking conditions
I have read, understand and agree to the booking conditions *

YES
Name of person completing the form
Please add me to your email list to receive communications about news and events
QUESTIONS? Call 416 766 7124 CONFIDENTIALITY OF INFORMATION: Information collected on this form will be used for Centauri Summer Camp Inc. purposes only Information will be used to process your enquiry and to send you future information either by electronic means or mail. We will not pass information onto any 3rd parties unless agreed by you in advance. If you wish to be removed from our lists, please contact us and we will remove your information. Go to http://www.centauriartscamp.com/about/privacy-policy/ to see our full privacy policy.
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Centauri Arts Academy Application