Studio Seven Center for Creative Studies Online Registration

Registration

Welcome to online registration for Studio Seven Center for Creative Studies! Please provide your information below! Please note, in order to reserve your student's place in class, the registration fee must be paid at time of registration. Thank you! NOTE: If you are registering in any of our CAMPS OR WORKSHOPS, you will NOT be assessed a registration fee.

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Referral Information

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Referral Name

Family Information

Family Last Name*

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Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name*

Last Name*

Type*

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Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications

Primary Doctor

Please see 'Course Descriptions' and 'Tuition' tabs on our website for further information on classes and tuition fees . PLEASE ALSO CLICK ON 'CLASS SCHEDULES,' AND OPEN THE LINK TO 'REQUIRED SUPPLIES AND FOOTWEAR.' THIS DOCUMENT WILL LIST EVERYTHING THAT YOUR STUDENT WILL NEED FOR HIS OR HER CLASS. Please make your class selections below. NOTE: Final placement in any level II or III class will be determined by the instructors within the first few weeks.

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Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications

Primary Doctor

Enroll in Classes

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Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications

Primary Doctor

Enroll in Classes

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Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications

Primary Doctor

Enroll in Classes

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Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications

Primary Doctor

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Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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