2009-2010 registration form
Child’s Name:__________________________________Age:_____________________Parent/Guardian Name:_____________________________________________________Address:_________________________________________________________Phone:_________________________Email: ___________________________ Emergency name and #:__________________________________________Class and Day:____________________________ Amount: ___________Food Allergies or developmental concerns: (please discuss in advance with Karen) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please check and initial one:I do _______________give permission for my child’s art to be displayed on the ArtisTRY website and in print materials.I do not____________give permission for my child’s art to be displayed on the ArtisTRY website and in print materials.Parent Signature ____________________________________ Date: _______________________________________Sorry, no reimbursement after the second classWeather cancellations follow the Arlington School System.Full tuition must be paid in advance.Mail to: Karen Dillon 38 Brantwood Road Arlington, MA 02476
