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Kids Art & Culinary Club 5779/2018-19 Registration Form

* Denotes required field

First Name*  
Last Name*  
Mother's First Name*  
Mother's Last Name*  
Father's First Name*  
Father's Last Name*  
Birthday*  
Jewish Birthday  
School*  
Grade*
Address 1*  
Address 2  
City*  
Province*  
Postal Code*  
Phone*  
Alternate Phone Number  

Email* 

 
   
~If your child chooses to attend a complete session, please do not check off individual lessons.~  
Session 1: Nov 3 - Dec 15  $ 84.00 - Member
Individual Lessons $15.00 
Please check events attending for the second session:
Sunday, November 3
Sunday, November 10
Sunday November 17
Sunday November 24
Sunday December 1
Sunday December 8
Sunday December 15
Session 2: Jan 12 - Feb 9  $ 60.00 - Member
Individual Lessons $15.00 
Please check events attending for the second session:
Sunday January 12
Sunday  January 19
Sunday  January 26
Sunday February 2
Sunday February 9


PAYMENT:

Total: 

Credit Card Type*

Credit Card Number*

Expiration Date*

Name on Card*


Notes (allergies...) :

*Note: Non-Members MUST reserve by weekly Wednesday 12 pm.

 

For more information please call 438-522-6256