Studio 4 the Arts Online Registration

Registration

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Studio 4 the Arts 2019 Registration

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Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)

Health Insurance Carrier

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

Student Email

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

$20 Summer Registration Fee Tuition is $85 for 6 weeks of classes in June and July Fees are not pro-rated & are non-refundable. $20 Fall 2019 Registration Fee for Returning Students $25 Fall 2019 Registration Fee for New Students $35 Fall 2019 Family Registration Fee

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

Student Email

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

Student Email

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

Student Email

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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

Student Email

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Parent Agreement

My child has permission to participate in Studio 4 the Arts, LLC programs. I waive the right to claim against Studio 4 the Arts staff and teachers in the event of accident, injury, or loss of personal items. I understand that Studio 4 retains the right to remove any student or parent from their program due to behavior issues or excessive unpaid fees. I understand that tuition is due by the first of each month & that I will be invoiced with a $15 late fee if not paid on time.
A. I understand that if I withdraw my child, I must do so in writing or email to tammy@studio4thearts.com. I can withdraw at any time. I will continue to be billed if this is not done in writing.
B. I understand that tuition is due by the 1st of each month. I will be invoiced with an additional $15 late fee if my tuition is not paid in a timely manner. My account must be up to date in order for my child to participate in the end of year Recitals.
C. I understand that in addition to tuition, I will pay a Costume Fee of $65 per costume (due in Nov.) & Recital Fees of $35 per student (due in April) in order for my child to participate in end of year Recitals.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule

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