Artistree

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South Pomfret, Vermont
802 457-3500
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Please complete the registration process

Please contact us if you have any questions.

STUDENT / PARENT INFORMATION (REQUIRED INFORMATION)
Student's Name:* Parent's Name: (if student is under the age of 18)
Female Male
Mailing Address (No & Street):*
Apartment:
City:* State:* Zip Code:*
Phone:* Email:*
CLASS INFORMATION
Class:*
Student's full name:*
Date of birth: (if student is under the age of 18)
Class:
 Student's full name:
 Date of birth:: (if student is under the age of 18)
Class:
 Student's full name:
 Date of birth:: (if student is under the age of 18)
ADDITIONAL STUDENT INFORMATION
What do you hope to learn (or hope your child will learn) by taking this class:
Is there anything we should know about you (or your child)? (i.e. fears, likes etc…)
PROMOTIONAL INFORMATION
How did you hear of Purple Crayon/Artistree?
FOR PARENTS / GUARDIANS DROPPING OFF ONLY:
I give permission for the following people to pick up my child/ren from Purple Crayon:
MEDICAL AND EMERGENCY INFORMATION
Special Needs? Yes No If yes, please provide details:
Allergies the teacher should be aware of:
If parents/Guardian can not be reached in case of an emergency, call:
Full Name
Relationship: Phone:
ACKNOWLEDGEMENT & ACCEPTANCE
*I agree and have read the Terms & Conditions
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