Student Enrollment Form All students may be placed on same form.


ADVENTURES IN ART Summer Art Camps 2018

Print this Page If you are new student please indicate male or female. Thank you!

Name(s)_____________________________(m,f)Age(s) _____ Grade(s) _____


Phone __________________ Parent’s Names _________________________

Cell phone_______________Email address___________________________

CLASS Location/Time/Dates________________________________

New student? _____

I give permission for my child to be treated in case of emergency at Mrs.Seitz’ discretion until I can be contacted.

Parent Signature __________________________________


1st Child $75 Paid Now___ Paid at 1st Class___

2nd Child $70 Paid Now___ Paid at 1st Class___

3rd Child $65Paid Now___ Paid at 1st Class___

4th Child $60 Paid Now___ Paid at 1st Class___

Subtotal: __________

If paid at least one week before class save $5 on total cost!

Total Cost: _________

Check No.:_________

Please send enrollment forms to: 2248 Fairfield Blvd. Plymouth, IN 46563

Make checks out to Gloria Seitz.

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