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REGISTRATION: Fall 2024 After School Art @ The Shine House
Please fill out this form for one student only. If multiple students per family are registering for memberships, each student will need this form filled out fully. Links will be provided upon submission to facilitate payment and further registrations.
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* Indicates required question
Email
*
Your email
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone Number (cell preferred)
*
Your answer
Student Name
*
Your answer
Student Age (the After School Art Program is available for students 13-18 years old)
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13
14
15
16
17
18
Art Room Membership or Study Room Membership?
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Art Room Membership $30/mo
Study Room Membership $15/mo (no art supplies included)
If art room membership is requested, what are your student's art interests?
Your answer
As parent/guardian of above student, I choose to give The Shine House permission to use images of my student taken during this event for marketing materials (including but not limited to Facebook posts, Instagram posts, flyers, and newsletters).
*
Yes
No
I verify that all above information is correct, and I, as parent/guardian of above student, am able to register my student for this program and am responsible for my student's conduct while at The Shine House.
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Yes
I understand and agree that The Shine House is not liable for personal injury, illness, or any other condition or effect that results directly or indirectly from my or my student's use of the facility.
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Yes
Payment
Payment is expected at the beginning of each month. We will send you an Eventbrite link each month to make payment simple, but for the first month, please click on link provided at the end of registration to continue on to the Eventbrite page for September's program. If you have any questions please contact tara@theshinehouse.com.
A copy of your responses will be emailed to the address you provided.
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