Name of Student (IMPORTANT! - Your child must be a first time after school art student) If your child loves the first class, and wants to take the remaining classes of the 8 week session, we will give you the discount code to pay for only the remaining 7 classes.

First Name

Last Name

Name of Parent

First Name

Last Name

Email Address

Which after school class do you wish to attend? (March 27, 28, 29 ?)

Emergency Cell Phone Number

(###)

###

####

Only kindergarten through 6th grade can attend. Please give EXACT age of child.

Dog Phobia?

Yes

How did you hear about Chris Babcock Art?