Education REGISTRATION FORM - Octagon Center for the Arts
Classes

Education REGISTRATION FORM

Please complete the registration form to register for: classes, workshops and special education department events.

Due to online form design, please only register one student per registration form.

Please call us with any questions or to register over the phone.

PLEASE CHECK THE WEBSITE CLASS LISTINGS TO SEE IF CLASSES HAVE BEEN CANCELLED

* denotes a required field.
General Information
Student Name: *
Age if under 18:  
Address: *
City: *
Zip Code: *
Cell Phone: *
Email Address: *
Day Time/Work Phone Number:  
Enter your phone number with no spaces or dashes between numbers.  
Emergency Contact/ Parent Name: *
In case of emergency whom should we contact?  
Emergency Contact Phone Number: *
Education Policies: *
Yes, I have read and understand the Octagon's registration, photography and refund policies. (If the answer is no, please visit the Education Policy section of our website, listed under Classes.)  
Class Information- Class Name: *
Please list the class you are registering for.  
Dates for the Class: *
Cost: *
Please note the cost of the class.  
Class Information- Class #2 Name:  
Please list the class you are registering for.  
Dates for the Class #2:  
Cost #2:  
Please note the cost of the second class.  
Allergies/Health Concerns:  
Please list any important and vital allergies or health concerns we should be aware of.  
Class Cost Total Before Discounts: *
Please enter the total of the above classes, before discounts have been taken.  
Membership Discount 10%:  
Please note your membership level if you are a member of the Octagon to receive your 10% discount on camps, classes, and workshops.  
Interested in a Membership at the Octagon?:  
Please note here if you are interested in learning about the wonderful membership opportunities that the Octagon Center for the Arts offers.  
Payment Information
Product Quantity Price Subtotal
Grand Total: * $
Price:    
Subtotal: 
 
Total Amount Due:  
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