Saturday Afternoon Kids Art Club©

 Registration Form

Dates: Any Saturday Afternoon 1-4 pm CT except during the month of August

 Location: Avalon Stained Glass School, 100 Dave Wintsch Rd., Munfordville, KY 42765

Please print down, print clearly and return with your child's registration fee to Avalon Stained Glass School, 100 Dave Wintsch Rd., Munfordville, KY 42765

Child's Name:__________________________

Child's age:___________

Address:______________________________ City:_________________________ State:___________________ Zip:________ Telephone number: (____)_____________

Email: ______________________@____________________

If your child has any allergies or disabilities, please list them.

_______________________________________

_________________________________________

None [  ]

[  ]  Registration Fee $25.00 includes 3 hrs. creative instruction and all materials.

Date you would like your child to attend:_____________

The registrations are first come first serve and are limited to only 8 children per session. We reserve the right to refuse any registrations for any reason whatsoever and we reserve the right to assign another date should the workshop you choose be filled.

Please sign below All participants must sign and date: I understand that I am solely responsible for any medical expenses which may result from any injuries, including those resulting from on-site injuries.

(If registering for minor child, guardian must sign. _____________________________ date __________

Signature of Child

____________________________ date ___________

Signature of Guardian or Parent

[ ] Please put me on your list for upcoming workshops and events. (Please note we do not sell or rent or share you email with anyone)