THERE ARE NO SUMMER WORKSHOPS SCHEDULED AT THIS TIME.
(SORRY, WE BOUGHT A BAY HOUSE)
Student(s) Name(s):_______________________________________ Age(s):____
Address:______________________________________________________________________
______________________________________________________________________
Home Phone: _________________________________________
Cell Phone: __________________________________________
Email:________________________________________________________________________
Emergency Contact : (Name and Phone number)
___________________________________________________________________________
Indicate ( 1 ) Session Choice Below:
SESSION I
Monday-Friday, July 15-19 11-2 PM $325 _______
SESSION II
Monday-Friday, July 22-26 11-2 PM $325 _______
Note: Another session and may be added as my family's summer schedule allows.
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
4112 Dresden Street, Kensington, MD 20895
VENMO PAYMENTS ALSO ACCEPTED.