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Class Registration Form:

               Young at Art WINTER 2020 SESSION    


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






Cell Phone  Parent 1: __________________________________________  


Cell Phone  Parent 2: __________________________________________





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