subject_line
Petite Palette
on the Gogh
Art & Cooking Classes
Contact:
321-277-5819
heidi@heidilifrage.com
http://heidilifrage.com
Participant Information
First Name
Last Name
Birth Date
(YYYY-MM-DD)
*
🛈
+
Current
Grade
3 Yrs
4 Yrs
K
1st
2nd
3rd
4th
5th
School Name
*
Household / Adult Primary Contact
Parent First Name
*
Parent Last Name
*
Relationship to Participants:
*
Mother
Father
Guardian
Other
Address 1
*
Address 2
City
*
State
*
Zip
*
Home Phone
Cell Phone
*
Email Address
*
Emergency Contact
Emergency Contact First Name
*
Emergency Contact Last Name
*
Emergency Contact Phone
*
Relationship to Child
*
Choose Your Camp Days
For which school(s) are you registering?
*
Brookshire Elementary
Lake Silver Elementary
St. Margaret Mary
St Mary Mag
Princeton Elementary
Audubon Park Elementary
Wednesday and Thursday Sessions are now closed.
Audubon Park
Art/130.00session
Wednesdays 2-3:30pm
Session I art
Session II art
Session III
Session IV
Session V
Session VI
Session III art
Audubon Park
Art - $130/session
Thursdays 3-4:30pm
Session I
Session II
Session III
Session IV
Session V
Session VI
Lake Silver
Cooking- $130/session
Wednesdays 2-3pm
Session I
Session II
Session III
Session IV
Session V
St Mary Magdalene
Art - $120/session
Monday 3-4
Session I
Session II
Session III
Session IV
Session V
Princeton Elementary
Art - $120/session
Thursdays 3:00-4:00
Session I
Session II
Session III
Session IV
Session V
Session VI
Session VI
Princeton Elementary
Cooking - $130/session
Tuesdays 3:00-4:00
Session I
Session II
Session III
Session IV
Session V
Session VI
Brookshire Elementary
Brookshire
Cooking - $130/session
Tuesdays 3-4pm
Session I
Session II
Session III
Session IV
Session V
Session VI
Saith Margaret Mary Catholic School
Saint Margaret Mary
Art - $120/session
Tuesdays 3-4
Session I
Session II
Session III
Session IV
Session V
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