Enrollment Information
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Send registration with full payment to 9102 Locarno Dr., Dallas, TX  75243

Classes will be filled "first come first serve" -  No refunds for cancellations

Student Name

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Age

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Birthdate

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Session Date                                     Morning     Afternoon  

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Parent/guardian name

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Address

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City/Zip

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Phone (home)

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Phone (work)

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Phone (cell)

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E-mail

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School friends also attending this class

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Doctor                                                               Phone

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Allergies

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Emergency Contact                                             Phone

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I hereby release Artzy Smartzy and its instructors and employees from any and all liability by reason of any accident or of any injury suffered by said child while engaged in activities.


Parent's Signature

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Date

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ArtzySmartzy < Art to Make you Smart!
Copyright © 2004