Arts in Blue Online Registration

Registration

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Welcome to Arts in Blue! We look forward to being in community with you! PLEASE NOTE: A valid credit card is required to complete the registration form. Payments are not automatically deducted. Registration Fee and first month's tuition is due on the first day of participation. Tuition for all students is $115 for October. Thank you!

* 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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies *

Medications*

Primary Doctor

Immunizations YN

Immunization Notes

Please click on the Search button below, then choose the 2025 - 2026 Registration Class All Students

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies *

Medications*

Primary Doctor

Immunizations YN

Immunization Notes

Please click on the Search button below, then choose the 2025 - 2026 Registration Class All Students

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies *

Medications*

Primary Doctor

Immunizations YN

Immunization Notes

Please click on the Search button below, then choose the 2025 - 2026 Registration Class All Students

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies *

Medications*

Primary Doctor

Immunizations YN

Immunization Notes

Please click on the Search button below, then choose the 2025 - 2026 Registration Class All Students

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies *

Medications*

Primary Doctor

Immunizations YN

Immunization Notes

Please click on the Search button below, then choose the 2025 - 2026 Registration Class All Students

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
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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)

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

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

Credit Card

Required Policies

(Show-Hide Details)