Class registration form

Class-Registration-Form

CLASS REGISTRATION FORM

**TWO STEP REGISTRATION - Payment required to complete the registration**

CLASS REGISTRATION

Student Name

Date of Birth (if minor) / Adult (for others)

Grade

Parent / Guardian Name

Address

City

Postal Code

Email address

Phone 1

Phone 2

Emergency Contact (if different from above)

Phone

Medical or other conditions requiring special attention

Medical text

ArtVenture will seek medical attention in the event of an emergency and will contact the emergency contact above. Please let us know if you have specific instructions for emergencies.

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Yes please

No thank you

Signature

I'm authorized to complete and submit this form

Agreement

By submitting the registration form you agree to the terms and conditions

Pictures Text

Occasionally we take pictures of students in class and their art for promotional literature and for our website.

If you have any concerns please talk to our staff.

#3-1438 Aldersbrook Road

London, Ontario N6G3V7

Phone: 519.471.4278

E-mail: info@artventure.ca

CLASS REGISTRATION

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