Arts & Learning :: Online Application

Untitled Document

Online Application

Please fill out all fields in the application. Incomplete forms cannot be processed. Thank You.

Class Information: Please input which session(s) your child is interested in participating:
Exploratory Arts I	Theatre Arts
Exploratory Arts II	Acting
Voice	Dance
Orchestra
Please list the production(s) in which your child would like to participate.*
Costume Sizes (Please indicate shirt, pant and shoe sizes)
Child Information:
First Name*	Last Name*
Gender*	Date of Birth*
Street Address*	City*
State*	Zip Code*
Parent Information: Fill out completely. Visit the Parents' Corner for more information.
Father's Name	Mother's Name
Father's Home Phone	Mother's Home Phone
Father's Cell or Work Phone	Mother's Cell or Work Phone
Please Indicate any area(s) of interest to volunteer (write unsure if not decided yet) click here for volunteer opportunities: *
Volunteers Needed!* Yes, I will volunteer No, I will pay the non-participation fee of $100
Medical Information:
Name of Health Insurance*	Name of Policy Holder*
Policy Number*	Family Doctor's Phone
Family Doctor's Name	Emergency Contact Phone*
Emergency Contact Name*
Please list all additional medical information (allergies, medications, current treatments, activity restrictions, etc). Write 'none' if none:*
Your email address*
How did you hear about Arts and Learning?














Submit
*Required

Untitled Document


	Thank You!

	Thank you for registering your child! *Please download and print the following waivers*. You may mail them to the address below or fax them to (866) 287-0715. click here for waiver forms For your convenience, you may either use the buttons below to remit tuition, or mail a check or money order to: Arts & Learning 11422 Jola Ave Garden Grove, CA 92843 Please contact info@artsandlearning.com if you have any questions. Click here to see details about the upcoming Aladdin show.