Wee Art
Parent and child class for ages 3 - 5.
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Student's First Name *
Student's Last Name *
Address *
City *
State *
Zip *
Age *
Birthdate *
Gender *
Medical Conditions *
(seizure disorder, diabetes, allergies, ect.)
Doctor's Name
Doctor's Phone Number
Emergency Contact Person's Name *
Adult other than parent
Emergency Contact Person's Phone Number *
Parent's First Name *
Parent's Last Name *
Home Phone Number *
Cell Phone Number *
Work Phone Number *
Place of Employment *
Email Address *
Other Parent's First Name
Other Parent's Last Name
Home Phone Number
Cell Phone Number
Work Phone Number
Place of Employment
Email Address
Are you a Center Member? *
How did you hear about our classes? *
Required
Class Payment Method *
I am aware that classes in the visual and performing arts carry with them the risk of physical injury. On behalf of my child, I assume the risk and agree that Thomasville Center for the Arts, and the Staff of this institution shall not be liable in any I am aware that classes in the visual and performing arts carry with them the risk of physical injury. On behalf of my child, I assume the risk and agree that Thomasville Center for the Arts, and the Staff of this institution shall not be liable in any way for injuries sustained during classes, rehearsals, performances, field trips, other Center activities or any of its related functions.way for injuries sustained during classes, rehearsals, performances, field trips, other Center activities or any of its related functions. *
I agree that images of my child may be use for publicity purposes by the Thomasville Center for the Arts. *
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