2020 Winter/Spring Semester Social Arts 102 On-Line Registration
Your student's registration will be confirmed via email after receipt of registration and payment.

Please note that this class will be held January 24, February 21, March 20, April 17, and May 8.
Email address *
Student's Name *
Your answer
Student's Date of Birth *
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DD
/
YYYY
Student's Age *
Your answer
Student's Gender *
Parent or Guardian *
Your answer
Phone Number *
Your answer
2nd Parent or Guardian
Your answer
2nd Phone Number
Your answer
Mailing Address with Zip Code *
Your answer
Contact Email Address *
Your answer
Are there any concerns that the student has that the instructor should know about, i.e. food allergies, learning differences? *
If the answer to the preceding question was yes, please explain below.
Your answer
Are you available to chaperon a lesson? If so please indicate your preferred date.
dates are listed by weekend, you would be asked to chaperon your student's lesson
By clicking below, I agree that neither Social Arts Atlanta, LLC or Zak Holdings, LLC nor any of its employees, independent contractors, directors and/or officers will be held liable for any injury which may occur to my child while attending programming. I hereby release Social Arts Atlanta, LLC or Zak Holdings and their respective employees, independent contractors, directors and/or officers from any and all legal or financial claims. I give permission for Social Arts Atlanta, LLC to use images of my child taken while participating in programming for public relations. *
Parent or Guardian *
Your answer
A copy of your responses will be emailed to the address you provided.
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