Studio 4 the Arts Online Registration

Registration

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STUDIO 4 THE ARTS REGISTRATION REGISTER FOR SUMMER NOW - FALL REGISTRATION STARTS MAY 1. Email tammy@studio4thearts.com with any questions or if you need assistance with your Registration.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

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*

Birth Date*

Additional Info

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Summer Class Registration is $25

Summer Camp Registration is $50 & this will go towards your Camp Fee

Summer Pop-Up do not have a Registration Fee

You will receive a confirmation email with instructions on how to login to your account. Your spot is not saved in the class until the Registration Fee is paid.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Summer Class Registration is $25

Summer Camp Registration is $50 & this will go towards your Camp Fee

Summer Pop-Up do not have a Registration Fee

You will receive a confirmation email with instructions on how to login to your account. Your spot is not saved in the class until the Registration Fee is paid.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Summer Class Registration is $25

Summer Camp Registration is $50 & this will go towards your Camp Fee

Summer Pop-Up do not have a Registration Fee

You will receive a confirmation email with instructions on how to login to your account. Your spot is not saved in the class until the Registration Fee is paid.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Summer Class Registration is $25

Summer Camp Registration is $50 & this will go towards your Camp Fee

Summer Pop-Up do not have a Registration Fee

You will receive a confirmation email with instructions on how to login to your account. Your spot is not saved in the class until the Registration Fee is paid.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Summer Class Registration is $25

Summer Camp Registration is $50 & this will go towards your Camp Fee

Summer Pop-Up do not have a Registration Fee

You will receive a confirmation email with instructions on how to login to your account. Your spot is not saved in the class until the Registration Fee is paid.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

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

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

(Show-Hide Details)