Artful Summer 2017
Teen Registration Form

Student's Information:

Student's First name:
Student's Last name:
Date of Birth:
Allergies or health alerts:

Are you registering more than one student?
Please write the other child(ren)'s name(s) and D.O.B. below:

Parent/Guardian's Information: First Name:
Last Name:
Cell Ph:
Address:
Address 2:
City:
State: Zip Code:
E-mail:
Emergency Contact:
Emergency Phone:
Artful Summer for Teens:

Choose Workshop(s):
Bookmaking $80
Calligraphy $80
Linoleum Printmaking $120

Supply list varies depending on workshop.

How did you hear Artful Summer?

Photo Release/Waiver:
Photos may be taken during class to post on Facebook.
Yes, I give permission to the teacher to photograph my child's artwork.
Yes, I give permission to the teacher to photograph my child during art camp.

Yes! I would like to receive email updates.

For additional comments please add them below: