Registration 2023 – The Artists Collective

Student NAME

DATE

ADDRESS

CITY

ZIP

DATE OF BIRTH

AGE

ETHNIC ORIGIN

SEX

SCHOOL ATTENDED

GRADE

ANY Disabilities

PRESCRIBED MEDICINE

Does your child suffer from: Asthma, Sickle cell, Lupus, other

Parent’s Name if under 18

Employer

Home Phone

Work Phone

Cell Phone

In case of emergency (Contact name)

Relationship

Home Phone

Work Phone

Cell Phone

HOW DID YOU LEARN ABOUT US?

Email

Performing Ensembles

Please Select Age Group

Select Children Membership Info & Rates

Fall semester music ($275)

Fall semester dance ($200)

Spring semester music ($275)

Spring semester dance ($200)

Select Adult Membership Info & Rates

Fall semester music ($300)

Fall semester dance ($250)

Spring semester music ($300)

Spring semester dance ($250)

Full Year: Tuesday, September 19, 2023 through Saturday, June 1, 2024
Fall Semester: Starting Tuesday, September 19, 2023
Spring Semester: Starting Tuesday, January 23, 2024

Music Workshops

Select Tuesday Music Workshop & Time

Select Wednesday Music Workshop & Time

Select Thursday Music Workshop & Time

Select Saturday Music Workshop & Time

Schedule, staff, and special events subject to change

Dance Workshops

Select Tuesday Dance Workshop & Time

Select Wednesday Dance Workshop & Time

Select Thursday Dance Workshop & Time

Select Saturday Dance Workshop & Time

* ROP – Rites of Passage Program
(Rites of Passage Cultural Arts and Education Program)

Schedule, staff, and special events subject to change

Additional Workshops

Select Workshop & Time

Total

Payment

Pay Now

Pay Later (cash/check)

Credit Card

Billing Address

City

State/Province

Zip/Postal

Country