2010 Summer Art Class Enrollment/Registration Form 

1. Print this form.
2. Make check payable to: Local Color Art Studio .
3. Mail completed form and check to:
   Local Color Art Studio/ PO Box 547824 / Orlando, FL 32854-7824
4. One student per Registration Form please.
5. Tuition:$150 for 1 week Mosaics(all materials included): either morning or afternoon
   - $275 for 2 Week Pottery classes(all materials included): both morning or afternoon
6. Please CHECK week and CIRCLE class or classes.

	Week	10:00-12:00 AM	1:00-3:00 PM
		(ages 5-12)
	June 14 - 18	Mosaics(individual-$150)	Mosaics(individual-$150) (parent & child - $275)
		$275 for both weeks	$275 for both weeks
	July 12 - 16	Pottery-1st week	Pottery-1st week(adults)
	July 19 - 23	Pottery -2nd week	Pottery-2nd week (adults)

  Enrollment is limited to 4-8 students per class. Register early!

Child's Name:                                                        Age:       Grade Entering:

Address:

City & Zip:

Home Phone:                                              Cell Phone:

Work Phone:                                               Email:

Parents Name:

Emergency Contact Name:

Emergency Contact Phone: