Arts & Learning :: Online Application

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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:
EAII: American Girl	EAI: Peter Pan
Age	Sherlock Holmes
Master Acting Class	Afternoon Voice


Please list the production(s) in which your child would like to participate.*
Costume Sizes (Please indicate shirt, pant and shoe sizes)
Child Information:	Last Name*
First Name*	Date of Birth*
Gender*	City*
Street Address*	Zip Code*
State*
Parent Information: Fill out completely. Visit the Parents' Corner for more information.	Mother's Name
Father's Name	Mother's Home Phone
Father's Home Phone	Mother's Cell or Work Phone
Father'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 cannot volunteer
Medical Information:	Name of Policy Holder*
Name of Health Insurance*	Family Doctor's Phone
Policy Number*	Emergency Contact Phone*
Family Doctor's Name
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

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	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. Commitment Policy Consent Form 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.