On-Line Registration Form

For Visual Arts, Media Arts, Theatre, Early Childhood Courses

Arts Umbella begins registration for all sessions (Fall, Winter, Spring) in June.

Register early to avoid disappointment. You may register for all three sessions at the same time.

APPLICATION TYPE

To Arts Umbrella you are: *

New Student

Returning Student

CHILD INFO

Last Name: *

First Name: *

Phone:

Address: *

City:

Postal Code:

Birth Date: *

Gender: *

Male

Female

PARENT INFORMATION TO BE COMPLETED BY NEW STUDENTS ONLY

PARENT A

Full Name:

Gender:

E-mail:

Cell Phone:

Work Phone:

Place of Work:

Occupation:

PARENT B

Full Name:

Gender:

E-mail:

Cell Phone:

Work Phone:

Place of Work:

Occupation:

STUDENT CONCERNS AND EMERGENCY CONTACT

I give permission for my child to take part in field trips & activities of Arts Umbrella: *

Are there any allergies, physical, emotional, learning needs, or other concerns that we may need to know about: *

If YES please explain:

Contact's Name: *

Contact's Phone:

Doctor's Name:

Doctor's Phone:

MSP Card No.:

PLEASE READ THE FOLLOWING REFUND AND TRANSFER POLICIES BEFORE COMPLETING REGISTRATION

WITHDRAWALS BEFORE THE SESSION BEGINS: A refund less a $25 administration fee per course will be issued if the request is received in writing at least 2 weeks prior to the start of the session.

WITHDRAWALS AFTER THE SESSION BEGINS: A withdrawal request must be received in writing no more than 48 hours after the second class. Arts Umbrella will retain 50% of the tuition fee. The remainder will be pro-rated and credited to your child's Arts Umbrella account, for use within one year.. After this time, no refunds will be issued. A pro-rated refund, less a $25 administration fee, will be issued when a withdrawal request is accompanied by a physician's note (note must be received within two weeks of withdrawal).

TRANSFERS: A request for transfer must be received in writing no more than 48 hours after the second class. Transfers will be made only if space is available. A $25 administration fee will be charged.

I have read and agreed to the above policies: *

YES

COURSE REGISTRATION
Please download the Program Course Schedule to access the program codes for registration

COURSE A

Course Name: *

Session: *

Course Code: *

Day & Time of Course: *

Fees:

COURSE B

Course Name:

Session:

Course Code:

Day & Time of Course:

Fees:

COURSE C

Course Name:

Session:

Course Code:

Day & Time of Course:

Fees:

PAYMENT

Fees to be paid in full upon registration We accept Visa, Mastercard, American Express.

Amount of Payment: *

Name of Card Holder: *

Credit card number: *

Expiry date: *

Signature (Email Address): *

*You will receive a confirmation e-mail in 2-3 business days when registered.