Fine Arts Academy Registration Form

Student Name: Last ________________________   First _________________________  

Is he/she currently enrolled at Village Christian?   Yes  (   )   No  (   )   Grade: _________

Name of Responsible Party: _________________________________________________

Relation to Student: _______________________________________________________   

Billing Address: __________________________________________________________

City: ______________________________    State: ______   Zip Code: _______________

Home Phone: (          ) _________________   Cell Phone: (          ) __________________

E-mail Address (please print): ______________________________________________

What class(es) is/are the student requesting? ____________________________________

·           Private Lessons . . . . . . . . . . . . . . . .         $30 per half-hour session given once a week

·           Group Art Classes . . . . . . . . . . . . . .         $15 per one hour session given once a week

·           Group Dance or Drama . . . . . . . . . .         $180 for twelve, one-hour sessions given

                                                                        twice a week for a total of six weeks

Would you be interested in helping with recitals and other events?     Yes  (   )     No  (   )

Will your child need to be taken out of child care?                                    Yes  (   )     No  (   )

The undersigned has read and understood the Fine Arts Academy Policies on the

back of this sheet and promises to abide by its regulations and guidelines.

* A $28 annual registration fee is attached *

________________________________________________            __________________

Signature of Responsible Party                                                  Date