private lessons registration

Payment is accepted through check, cash, or chase quick pay.

Student Name(s) (required)

Student Age(s) (required)

Contact Email (required)

Student Cell Phone

Student Address

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Emergency Contact:(required)

Emergency Contact Cell:(required)

Emergency Contact Work:

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Does the student have any any previous formal art training:

Does the student have any allergies or medical issues

Anything else we should know about, i.e. fears, dislikes, interests, special needs etc

Please let us know how you found out about SD Studios Art Rocks

Preferred dates/times for class
or

I agree to the release of photos that may be redistributed/shared (On web site, fliers, and social media)
I agreeI do not agree

Signature (required)

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Please Fill out if student is a minor:

1. Parent or Guardian Name

Parent Cell Phone Number

Parent Work Phone Number

Parent Address (if different from student)

2. Parent or Guardian Name

Parent Cell Phone Number

Parent Work Phone Number

Parent Address (if different from student)

School Your Child(s) Attends

How will your child be transported to SD Studios?

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