2017 Registration Form
Child’s Name:__________________________________Age:_____________________
Parent/Guardian Name:_____________________________________________________Address:_________________________________________________________Phone:_________________________Email: ______________________ Emergency name and #:__________________________________________
Registering for:____________________________ (Specify week please) Amount: ___________Food Allergies or developmental concerns: (please discuss in advance with Karen)
_____________________________________________________________________________________________________________________________________________________________________________________________Please check and initial one:I do _______________give permission for my child’s art to be displayed on the ArtisTRY website and in print materials.I do not____________give permission for my child’s art to be displayed on the ArtisTRY website and in print materials.Parent Signature ____________________________________ Date: _______________________________________Please mail completed registration form and tuition to Karen DIllon, 38 Brantwood Road, Arlington, MA 02476
Sorry, no reimbursement after the first class
Full tuition must be paid in advance.
ArtisTRY Studio
Creative Art Classes for Creative Children and Teens
