Kids Art Discovery Class Registration Kids Classes Registration Student InformationNOTE: You will need to sign the paper permission form before your child can start attending classes. If renewing, you only need to fill out required fields: student name and permissions. If new registration, please fill out everything that applies.New or renewal?* New Renewal Student* First Last Age*Please enter a number from 5 to 17.Student Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Father's Name First Last Father's Email Father's PhoneMother's Name First Last Mother's Email Mother's PhoneMedical and Emergency InformationLearning Problems Allergies Other adults who may pick up your child (ID will be required)Name First Last PhoneName First Last PhoneEmergency ContactsName of friend(s) or relative(s) in the area who may be notified if unable to locate parent(s). If a child becomes sick while at the center, the child MUST be picked up and taken home, if not picked up by you then by someone else. No exceptions.Name First Last PhoneName First Last PhonePermissions*I will notify the center if there is a change in the above arrangements. In case of an emergency, I understand the center will try to contact the parent. In the event that the parent cannot be reached, permission is given for the Art Center to take my child to an emergency hospital by ambulance if necessary. Yes No Permission to Photograph*I grant permission to the Art Center to take photographs of my child for the sole purposes of advertising, scrapbooking, and/or inclusion in local newspaper articles. Yes No Additional InformationInclude details about class requirements, preferred scheduling options, and any questions you may have.CAPTCHABase PriceTotal $0.00 Sale! Kids Art Discovery Class Supply Kit $70.21 $65.00 Add to cart Collins Artworks • 72A High St. Clinton, MA • (978) 368-3300 • email@example.comCopyright © Collins Artworks Art Center 2006-2022; All rights reserved.