PRINTABLE REGISTRATION FORM (printable form *.doc)

STUDENT NAME: ______________________ Gender (___M) (___F)

Age _____  School ________________ Birth date ____ / ____ / ____

Class Session:  Day of week ______________  Time _____________

PARENT/GUARDIAN NAME: ________________________________

Address __________________________________________________

City _____________________________________  Zip ____________

Home Phone ______________   Work Phone ____________________

Cell Phone ______________  Email Address ____________________

MEDICAL EMERGENCIES: The undersigned gives permission to Green Forest Art Studio, Inc. its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health. I request that our doctor/physician be called and that my child be transported to a hospital. Please include Hospital and physicians' phone number.

Emergency Contact (name, phone #) __________________________

Physician Name & Phone # __________________________________

Allergies / Known Medical Conditions __________________________

How did you hear about Green Forest? _________________________

TRANSPORTATION: Please list all who are authorized to pick up your child. Please give us a contact phone number as well. We take the safety of your children very seriously.

Name (s) ________________________________________________

PARENT'S AUTHORIZATION & WAVIER FORM: As the legal parent or guardian, I release and hold harmless Green Forest Art Studio, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Green Forest Art Studio its owners and operators or in route to or from any of said premises.

Parent's (or Guardian's) Signature ____________________________

Date Signed ____________

I give permission to Green Forest Art Studio to use photos taken of my child making art with Green Forest Art Studio AND/OR photos of my child’s artwork created at Green Forest Art Studio to be used in marketing Green Forest Art Studio's programs. (Your child’s first name, initial of last name, and age may be used in association with the image of his/her self and/or artwork.)

Parent's (or Guardian's) Signature ____________________________

Date Signed ____________

For office use:  Payment Received $________   Ck#______/ CASH

GREEN FOREST POLICIES

(Limited time promotional pricing)

Payment Option A: 10 week session for $250 ($25/class)

Payment Option B: 22 week session for $500 ($22.72/class)

Private Lessons (One-on-One): $75/hr

We currently accept cash or checks (payable to "Green Forest Art Studio, Inc.").  There is a $20.00 returned check charge for any checks returned by the bank.

Enrollment - Students will be enrolled on a "first come first served" basis.  Maximum class size is 8 regulsr students for each teacher present.

Minimum Class Size - If a class is canceled for under-enrollment, you will be refunded.

Missed Classes – There will be no refund for missed classes.  Missed classes must be made up during the 10 week (Payment Option A) or 22 week (Payment Option B) session.  After the session ends, the makeup is forfeited.

Guests – In order to not disturb the class, only registered students can stay in the classroom.

Pick-up and Drop-off – Parents / guardians are required to accompany students when arriving and departing.  Please drop off and pick up your child on time.  A fee of $1/minute will be charged for late pickups.

Waiting Area - A seating area is available for parents to wait for their children.

Washrooms - Children must be washroom independent, as no assistance will be provided.

Children may be removed from the program at the discretion of the instructor.

Classes & Schedule >