Registration
5 openings left in this event!
Register all attendees as a Student. Parent or Guardian must register with student. “Family Info” should match the cardholder’s name but all attendees must be registered as a “student". So if the person paying for the registration also wants to attend the Paint n Sip they must also be listed as a “student
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Release of Liability
  (Show-Hide Details)
I've read the above and agree.
 
Image Release Form
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I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*