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Youth Registration Form:
Student's Name ______________________________________ Age_______
Phone # (home)___________ Cell Phone #_____________
Address_____________________________________________
_____________________________________________
Parent/Guardian Name______________________________
Parent's/Guardian Daytime #________________________
I wish to enroll my child in:
____ Session I Cartooning with Mr. Ollie Cost: $70.
____ Session II with Mr. Ollie Cost: $70.
____ Session I Drawing with Mr. Jim Cost: $77.
____ Session II Drawing & Painting with Mr. Jim
Cost: $77.
____ Session I Tiny ACT Cost: $20.
____ Session II Tiny ACT Cost: $20.
____ Session I Theatre Sampler with Ms. Werts Cost:
$73.
____ Session II Theatre Camp with Ms. Werts Cost:
$73.
____ Session I Sculptural Puppets Cost: $70.
____ Session II Sculptural Puppets Cost: $70.
____ Adult/child pin hole photography Cost: $85.
TOTAL DUE ____________
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