Museo Art Academy Online Registration

Registration

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BUDDY DISCOUNTS AVAILABLE ON SELECT EVENTS, WORKSHOPS & CAMPS: Sign up with a friend and Save! In an effort to introduce more families to Museo Art Academy, and say "THANK YOU" to YOU for helping, we offer a buddy discount program for select programs--now exclusively through Facebook (weekly classes excluded). More info at: http://www.museoart.com/buddy-discount.html

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family (Last) Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or 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 # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

School*

Any disabilites?

Any special needs to be aware of?

Allergies?

Desired start date (mm/dd)*

Please select the desired class(es) for this student.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

School*

Any disabilites?

Any special needs to be aware of?

Allergies?

Desired start date (mm/dd)*

Please select the desired class(es) for this student.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

School*

Any disabilites?

Any special needs to be aware of?

Allergies?

Desired start date (mm/dd)*

Please select the desired class(es) for this student.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

School*

Any disabilites?

Any special needs to be aware of?

Allergies?

Desired start date (mm/dd)*

Please select the desired class(es) for this student.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

School*

Any disabilites?

Any special needs to be aware of?

Allergies?

Desired start date (mm/dd)*

Please select the desired class(es) for this student.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

PAYMENT OPTIONS

You must provide credit card info (VISA or Mastercard) in order to submit your registration. If you prefer to pay by cash or check, please state so in the "comments" section below and forward payment to 970 5th Ave. NW, Suite 120, Issaquah, WA 98027 (reference student's name on check). We will temporarily keep your credit card information on file to hold your place in class (space permitting) until cash/check payment is received. Please Note: Payment MUST be received in order to confirm your registration.

I've read the above and agree.

POLICIES

Policies are posted online at http://museoart.com/policies/. Please indicate that you have read and agree to comply with those policies in their entirety by checking the box. UPDATED 12/24/16.

I've read the above and agree.

PHOTO RELEASE

With the understanding that all images will be identified by student's first name and age only (if a minor), Museo has my permission to display photos of student on its website, in the studio and in other promotional materials. NOTE: You may request (in the comments box on this form) to "only show images of student's artwork, and not allow use of photos of student".

I've read the above and agree.

MEDICAL RELEASE

In the event of a medical emergency, I accept full responsibility for any accident or injury that may occur and request that the student be admitted to any hospital or medical facility for diagnosis and treatment.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

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*