Registration form Name of Class: Painting Class Day: Saturdays Class Time: 9:30-10:30am Date of Birth: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 19701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016 Parent/Guardian 1 Parent/Guardian 2 State: New JerseyAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Accept Enrollment Conditions Yes Photo Release YesNo By checking this option, you consent and agree that Urban Arts or its agents have the right to take photographs, videotape or digital recordings of your child to use in any media exclusively for Urban Arts' publicity purposes.
