Grand Central Atelier Part-time Class Registration Form 2017/18
Please complete this form to sign up. Payment is due at this time.
First Name
Your answer
Last Name
Your answer
Zip
Your answer
Phone
Your answer
Email
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
Your answer
Emergency Contact Email
Your answer
Which specific class are you registering for?
Required
Do you have any physical considerations we should be aware of?
(such as left-handed, must have a seated position)
Your answer
Method of Payment
Credit card payments are due upon submission of this form. Please return to the website to make a payment. Only credit cards payments can be used for an installment plan for night and weekend workshops. If paying by cash or check, your spot will be held for one week until payment is received.
How did you hear about the GCA?
Your answer
Please read the Code of Conduct online and the Student Contract below. Your typed signature signifies your acceptance of its terms.
Submission of this signed form signifies my acceptance of the terms stated in the Code of Conduct and this agreement that the Grand Central Atelier (GCA) cannot be held responsible or liable to me for any injury, illness, death, damage, loss or accident which may occur during any program. Personal belongings, art and art supplies are solely my responsibility at all times. GCA reserves the right to cancel or reschedule any class in which case it is liable only for the tuition I paid to the GCA. GCA reserves the right to cancel my enrollment in the event of any disruptive or unlawful behavior without refund to me. I understand I am obliged to abide by the payment terms listed on our website. Unless otherwise informed, GCA considers photographs taken during classes and workshops of students and student art permissible for publication in print and on the web.
Your answer
Signature of Guardian (for minors)
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