Celebrate ART Class Registration Form |
Student's Name:_________________________________________________________________________ DOB:______________________
Parent's Name: Mother:___________________________________________ Father:___________________________________________
Address:_______________________________________________________ City:_________________________ Zip:__________________
Home Phone:(____)______-__________ Alt. Phone:(____)______-__________
Email:______________________________________________________________________________________________________________
Allergies, medical or dietary restrictions:_______________________________________________________________________________
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Emergency Contact Information |
Name:_______________________________________________________________________ Relationship:________________________
Daytime Phone:(____)______-__________ Alt. Phone:(____)______-__________
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Class Enrollment Information |
Class & Time:_____________________________________________________________________________________ $____________
Class & Time:_____________________________________________________________________________________ $____________
Class & Time:_____________________________________________________________________________________ $____________
Class & Time:________________________________________________________________________________ Total: $____________
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All Classes held at: Celebrate ART
603 Main St., Redwood City, CA.
For more info call us at (415)867-7688
Make checks payable to: Celebrate ART
Mail to: 1240 Woodside Rd. #26 Redwood City, CA 94061
Please print this form and mail along with your payment
Email confirmation will be sent within five business days of receipt of registration
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Waiver |
I hereby agree to hold Celebrate ART, their program and activity instructors, harmless from all liability which may arise as a result
of participation in class activities. I hereby give my permission for my child to participate in the activities listed above and also agree to hold Celebrate ART,
their program and activity instructors, harmless from all liability which may arise as a result of said minor's participation in such activities.
I understand that the above named activities may involve risk, accidental injury, soiling of clothes, or other incidents and hereby voluntarily assume such risks.
( If participant is a minor, a parent or guardian must sign below )
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I have read and understand the above information. |
(Parent/Guardian) Signature:_______________________________________________ Date:_____________________
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