Registration form

Name of Class: Special%20Needs%20(21yrs%20-%20Up)
Class Day: Fridays
Class Time: 1:00-2:30pm

    Date of Birth:

    Parent/Guardian 1

    Parent/Guardian 2

    State:

    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.