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Class Registration Form:

               Young at Art WINTER 2020 SESSION    

                            

Student(s) Name(s):_____________________________________________________ Age(s):____

 

Address:______________________________________________________________________

 

            ______________________________________________________________________

 

Cell Phone  Parent 1: __________________________________________  

 

Cell Phone  Parent 2: __________________________________________

 

Email:________________________________________________________________________

 

 

Optional Additional Contact Cell Phone (carpool, nanny etc.) : 

 

___________________________________________________________________________

 

Indicate  Class Choice Below:

 

Young at Art I   

 

     Mondays, Jan.13-Mar.16,  4:15-5:30 pm ____ or   Wednesdays, Jan.15-Mar.18, 4:15-5:30 pm ____ ($295) 

          

 

Young at Art II / Middle School Open Studio

 

     Mondays, Jan.13-Mar.16,  6-7:30 pm    _____   or   Wednesdays, Jan.15-Mar.18, 6-7:30 pm ____  ($325)  

             

                *There will be no classes March 9 or 11....I will be away for my birthday!

 

           

  I/We the undersigned, parents of, ______________________, a minor, do hereby release and hold harmless Young at Art and Nancy and Mark Altemus (hereinafter “owner”) from any claims for  personal  injury or other damage arising from my/our child’s attendance and participation in the program located at 4112 Dresden Street, Kensington, MD 20895.                                                                                           

 

 

 

___ Please check here if you DO NOT GIVE PERMISSION for your child's photograph or art work to be on our website.

 

 

Parent Signature:____________________________________________________Date:___________

       

 

                                        Please print out form and mail with payment to: 

                                                       Nancy Myers Altemus, YOUNG at ART

                                                               or VENMO @Nancy-Altemus

                                              

                                            4112 Dresden Street, Kensington, MD 20895