Register Now Please print this page and fax to 561-792-7731 or mail to: ArtStart, Inc. 750 Cedar Cove Rd., Wellington FL 33414. Registrations also accepted by telephone: 561-635-2037. Name:__________________________________________________________ Student's Name: _________________________________________________ Address:________________________________________________________ City, State, Zip:__________________________________________________ Telephone:______________________________________________________ E-mail:_________________________________________________ Enclosed is my registration $___________________________ Please charge my: Visa___ MasterCard___ AmEx___ Discover___ (A 5% processing fee will be added to all card payments.) Card Number:___________________________________________________ Expiration Date:______________3-digit security code on back of card:_____ Check Enclosed:________ Signature:_________________________________________________ Class Name: ____________________________________________________ Session Dates: __________________________________________________ Parent Guardian Signature: ________________________________________ ArtStart Signature: _______________________________________________ Each party to this contract hereby agrees to save and hold harmless the other from all cost, injury and damage to any person or property whatsoever, any of which is caused by an activity, condition or event arising out of the performance, preparation for performance or nonperformance of any provision of this agreement by either party, its agents, or any of its independent contractors. ArtStart, Inc. is a 501(c)(3) corporation and contributions are deductible to the extent of federal law; Tax ID# is 84-1665568. A COPY OF THE OFFICIAL REGISTRATION #CH18965 AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.
Please print this page and fax to 561-792-7731 or mail to: ArtStart, Inc. 750 Cedar Cove Rd., Wellington FL 33414. Registrations also accepted by telephone: 561-635-2037.
Name:__________________________________________________________ Student's Name: _________________________________________________ Address:________________________________________________________ City, State, Zip:__________________________________________________ Telephone:______________________________________________________ E-mail:_________________________________________________ Enclosed is my registration $___________________________ Please charge my: Visa___ MasterCard___ AmEx___ Discover___ (A 5% processing fee will be added to all card payments.) Card Number:___________________________________________________ Expiration Date:______________3-digit security code on back of card:_____ Check Enclosed:________ Signature:_________________________________________________ Class Name: ____________________________________________________ Session Dates: __________________________________________________ Parent Guardian Signature: ________________________________________ ArtStart Signature: _______________________________________________ Each party to this contract hereby agrees to save and hold harmless the other from all cost, injury and damage to any person or property whatsoever, any of which is caused by an activity, condition or event arising out of the performance, preparation for performance or nonperformance of any provision of this agreement by either party, its agents, or any of its independent contractors.
