Class Registration Form

REGISTRATION FORM - FALL 2025

STUDENT NAME(s):____________________________________________ AGE(s)__________

ADDRESS:__________________________________________________________

__________________________________________________________

CELL PHONE PARENT 1: __________________________________

CELL PHONE PARENT 2:__________________________________

Other CELL CONTACT: __________________________________

EMAIL:_____________________________________________________________

ART CLASS CHOICE:

MONDAYS, 4:15-5:30 PM (9/15-11/3) _____________ $325

TUESDAYS, 4:15-5:30 PM (9/16-11/4) _____________ $325

WEDNESDAYS, 4:15-5:30 PM (9/17-11/5) __________ $325

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

PARENT SIGNATURE:______________________________________________________

SEND PAYMENT TO:

NANCY ALTEMUS/YOUNG AT ART

4112 DRESDEN STREET, KENSINGTON, MD 20895

301-801-4438

CHECK OR VENMO @NANCY-ALTEMUS