Bainbridge Chinese Culture & Arts

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Private Lesson Registration Form

Class Type/Fee (please select one) *

$40 per hour lesson for one student

$50 per hour lesson for two students

Required

Student Information

Name of Student (First/Last) *

Address: *

Phone (home & mobile) *

E-mail: *

Emergency Contact Info

Emergency Contact (Name/Phone) *

Family Physician (Name/Phone) *

Thank You For Registering

Please click "Submit" button below to complete the registration.

Please notify the administrator for class arrangement and faster service.

Please contact us at admin@bainbridgechinese.org or (206) 486-0826 if you have any questions.

Bainbridge Chinese Culture & Arts
P.O. Box 11681
Bainbridge Island, WA 98110

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