Summer 2007 Registration

Registration  Information

Name(s) of Parent(s) _________________________________________________________________________

Title ______________________________________________________________________________________

Address: __________________________________________________________________________________

City: ___________________________________   State/Province_____________ Zip/Postal Code ___________

Home Phone_______________________________________________________________________________

Work Phone_______________________________________________________________________________

Cell Phone_________________________________________________________________________________

Email____________________________________________________________________ (Required for Paypal)

Emergency Contact__________________________________________________________________________

Emergency Phone___________________________________________________________________________

How did you hear about us? ___________________________________________________________________

Whom may we thank for your referral?__________________________________________________________

Name of  First Child ________________________________________________________________________

Preferred Nickname________________________________________________________________________

Date of Birth ____________________________________ Shirt Size _________________________________

Food Allergies ____________________________________________________________________________

Class/Day/Time ___________________________________________________________________________

Name of Second Child _____________________________________________________________________

Preferred Nickname _______________________________________________________________________

Food Allergies ___________________________________________________________________________

Date of Birth ____________________________________ Shirt Size ________________________________

Class/Day/Time __________________________________________________________________________

Name of Caregiver attending class other than parents ___________________________________________

Total Tuition Enclosed _____________________________________________________________________

In order to ensure your child's place in class, a $75.00 deposit is required which will be applied to the total cost of your class.  Deposits are used to purchase class supplies and are non-refundable.  If you wish to take advantage of the Early Bird Discount, payment in full must be made by May 10, 2007.  Full payment of tuition is required by the first class.  Once class is attended and a supply kit is received, you are obligated to pay the entire fee.  I understand that my child's place in class is not guaranteed until full payment is received.  * Photo Release: I do____ do not____  give permission for my child/ren to be photographed for promotional materials including web site postings. I do so without expectation of compensation & with the understanding that these photos will be used exclusively by Masterworks Studio.  I also acknowledge that Masterworks Studio may choose not to use my photo at this time, but may do so at its own discretion at a later date.  I also understand that once my image is posted on Masterworks Studio's website, the image can be downloaded by any computer user. Therefore, I agree to indemnify and hold harmless from any claims Merri Williams or Masterworks Studio. By submitting this form, you are signifying that you agree to this policy.  Checks should be made payable to Masterworks Studio and mailed to 4604 Thompson Mill Road, Decatur, GA 30034-2521.  For your convenience, if you prefer to pay on line with a credit card, click here and find your preferred class to register.  You do not have to have an account with Paypal.com or Eventbrite to utilize this free service.  Confirmation of your child's enrollment will be sent online.  I have read the policies above and am in agreement with them.

Signed _________________________________________________________________________

Date ___________________________________________________________________________

Thank you for your registration!