ATI Bringing Art to Life Online Registration

Family Information

Parent/Guardian Name*

First Name

Last Name

Parent/Guardian Email*

Parent/Guardian Phone Number*

Student Name*

First Name

Last Name

Student's Age*

Student Email*

Student Phone Number*

Registration and Payment

Registration for this course costs $300. Your registration fee cannot be refunded under any circumstances. To be fair and transparent, we cannot make exceptions.

Were you referred by a current family? If so, who referred you?*

No Yes

Please provide the name of the current family who referred you so that we can verify. *

First Name

Last Name

Course registration payment* $

Quantity

Credit Card*

Name of Cardholder*

First Name

Last Name

Billing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Cardholder Signature*

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Use your mouse or finger to draw your signature above

Cardholder: This is to acknowledge that I have read and understood, and agree to abide by all terms and conditions of my registration with ATI Online. I understand that my registration payment is non-refundable and confirm my student's place in the ATI Online program.

Signer Name*

First Name

Last Name

Student Agreement: Community Norms and Expectations

We are excited to welcome you to the ATI Online community and welcome your ideas and participation. We expect that as a new member, you will do your best to uphold the norms and expectations that help us all learn productively and joyfully. This includes treating students and staff with kindness and respect, communicating responsibly, and being curious and open to other people and their ideas.

I've read and agree to the above terms and conditions.

Student Signature*

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Submitted Date