Registration

*Parent Name

*Parent Address

*Parent Email Address

*Parent Phone Number

*Emergency Contact Name

*Emergency Contact Phone Number

Allowed Escort Name

Allowed Escort Phone Number

*Student 1 Name

*Student 1 Age *Student 1 AgeStudent 1 Age: 4Student 1 Age: 5Student 1 Age: 6Student 1 Age: 7Student 1 Age: 8Student 1 Age: 9Student 1 Age: 10Student 1 Age: 11Student 1 Age: 12

Other Information (allergies, special needs, etc.)

Group Classes (Student 1) Group Classes (Student 1) Monday, 4:00pm (ages 7-11) Tuesday, 1:30-2:30pm (ages Pre-K) Tuesday, 4:00pm (ages K–2nd grade) Wednesday, 3:30pm (ages 6-8) Thursday, 3:30pm (ages 8-12)

Student 2 Name

Student 2 Age Student 2 AgeStudent 1 Age: 4Student 1 Age: 5Student 1 Age: 6Student 1 Age: 7Student 1 Age: 8Student 1 Age: 9Student 1 Age: 10Student 1 Age: 11Student 1 Age: 12

Other Information (allergies, special needs, etc.)

Group Classes (Student 2) Group Classes (Student 2) Monday, 4:00pm (ages 7-11) Tuesday, 1:30-2:30pm (ages Pre-K) Tuesday, 4:00pm (ages K–2nd grade) Wednesday, 3:30pm (ages 6-8) Thursday, 3:30pm (ages 8-12)

Additional Artist Name/Age/Selections

Where did you hear about us?