Class Registration Form
Elk Grove Space 4 Art Class Registration Form
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Student's Name *
Student's Age *
5-8 yrs old Class
9-11 yrs old Class
11+ yrs old Class
Email Address *
Parent/Guardian's Name *
Parent/Guardian's Cell # *
In the event of an emergency, whom do we call if we cannot reach you?  (Name) *
Relationship *
Phone # *
Medical or any other information we should know?  (Including food allergies)
Elk Grove Space 4 Art is allowed to use photos of your child in promotional brochures, news articles, webpages or other literature published by or for the art class. *
Typing my name below is indicative of the fact that I have read and understood the information contained herein and agree to comply with them.  In consideration of the opportunity afforded to the undersigned to participate in any art class activity, the undersigned hereby knowingly, freely, and voluntarily waives any right or cause of action against Elk Grove Space 4 Art (Space 4 Art Jam LLC), its officers, agents, and/or employees out of any claim whatsoever as a result of any injuries to body, life, limb, or property arising from participation in the hereinafter described activity.  The undersigned shall save harmless the Space 4 Art Jam from and against all judgements, orders decrees, attorney fees, costs, expenses, and liabilities arising from or out of such claim, investigation, or defense thereof which may be entered, incurred, or assessed as a result of the foregoing.  (Please type in your full name) *
I hereby give my/our consent for my/our child, when ill/injured, my/our child shall receive first aid or be taken to the nearest emergency when I/we cannot be contacted.  I consent to an ambulance being called to transport the child, if necessary and further agree to pay all costs incurred for transportation.  (Please type in full name of your child) *
Received 5% Sibling Discount 
All art materials are including in the tuition 
Payment Option (We will email you an invoice after we received your registration form) *
Studio Policy
Please read the Studio Policy and check the box below before submitting the registration form.

*Please note that all art/ceramic class credits at EG Space 4 Art need to be used within six months from the date of purchase. Unused credits will be forfeited for absences without notification after this six-month period.
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