Firstlight CLASS Registration Form
School-year program
To register for art classes, please submit this completed form (as complete as is possible for whatever your situation is.), and use the link following to make your payment. (Or, you may mail a check, payable to Firstlight, to our office at: 109 Chapelwood Ln, Franklin, TN 37069). We require one tuition installment payment of $98 plus the yearly registration fee of $25 per student to reserve a spot ($123 total). Each class meets 35 times - August through May, (or the 16 week adult shortcourse), and registration is a full commitment to the class. See our policies for more information. Email or call to check availability. There are many new classes, so you should be able to find an open spot easily!
ADULT students only need to fill out the GREEN Items
Bold items are required. Really!

Adult first name:

 (Main contact if parent)
Last name:

Email address:
(Please double-check it!)

Cell Phone: w/area code

 please add hyphens and area code
Home Phone:
Street address:
City: State: Zip:
Other parent/spouse name & any important info.

Cell Phone: (w/area code)
Second email to copy on announcements about class: (can be student's)
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First Student Information Self Son Daughter Other:
Name (if not yourself):
Art Class ID # (ie:404) & Title
Date of Birth (if Child)

Grade for 2010-2011
Let us know about your child Provide information that you think is important. (ie: previous classes, ADHD, or medications)
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skip next 2 parts if only enrolling one student
Second Student Info Self Son Daughter Other:
Name: Goes by:
Date of Birth (Children only)

Grade for 2010-2011
Art Class ID # (ie: 404) & Title
Let us know about your child
Third Student Info Self Son Daughter Other:
Name:
Date of Birth (Children only)

Grade for 2010-2011
Art Class ID # (ie: 404) & Title
Let us know about your child
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Extra Emergency contact:

 (not parent. We will always attempt to contact parents first)

Cell Phone:

Home Phone:
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MEDICAL Info for child enrollments:
Doctor's Name: Phone:
Medical Insurance Carrier: Phone:
Policyholder's name Policy #:
Liability release: I, , hereby release Dennas Davis, Firstlight Arts Academy, its agents, employees, and volunteer assistants from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by the above-named student while participating in classes and activities offered by Firstlight. In case of emergency, I grant any staff or faculty member of Firstlight Arts Academy permission to seek medical care for the above-named student(s).
Agree --- date:
Do not agree (cancels registration)
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How did you hear about Firstlight?


(online ad, search, mailing, ad, friend, sign, truck, etc.)
Policies I have read and understand Firstlight's policies.
SUPPLIES
Check this if you want to reserve a supply kit(s). You can pay AFTER you finish the registration form by clicking on the supply link at the top of each page. Or you can purchase at the studio before or on your first class day.		 I would like to reserve a supply kit for each enrollment above. (If you want something else, please email. thanks)
Foundations supply kit: $150.02 plus tax
Toons supply kit: $125.60 plus tax
supplies should take you through the entire school year.
Commitment
(If you need to cancel an enrollment, you can do so with a 30-day advance written notice submitted before February 20th)		 I understand that space is limited and that by registering, I'm commiting to the full 35 classes for the above enrollment(s).
Agree --- date:
Do not agree (cancels registration)
Please review your information before submitting. Press "Submit" to complete the form and proceed to a payment page
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