J'S ART STUDIO REGISTRATION FORM

STUDENT NAME__________________________________________________AGE________________________
PARENTS NAMES:____________________________________________________________________________
HOME ADDRESS:_____________________________________CITY____________________ZIP______________
HOME PHONE:_______________________________________WORK___________________________________
CELL:_________________________________OTHER_________________________________________________
EMAIL ADDRESS __________________________________
EMERGENCY CONTACT:___________________________________________PHONE:______________________
CAMP DATE AND TITLE________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
MORNING OR AFTERNOON_________
HOW DID YOU HEAR ABOUT US? ________________________________________________________________

PLEASE REMEMBER TO ENCLOSE A DEPOSIT CHECK FOR $90.00 PER CAMP/PER CHILD.
THE BALANCE WILL BE DUE ON THE FIRST DAY OF CAMP
J'S ART STUDIO
17630 DAVENPORT RD. SUITE 102
DALLAS, TEXAS 75252
972-931-1933