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Summer Workshops 2019 Registration Form:


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






Home Phone: _________________________________________ 


Cell Phone: __________________________________________





Emergency Contact : (Name and Phone number)




Indicate ( 1 ) Session Choice Below:  




    Monday-Friday,    July 15-19            11-2 PM                  $325         _______





    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.




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