Academy for Emerging Artists Registration (At Galerie Elan)
248 S Beach St, Daytona Beach, FL 32114 (386) 871-9906
Student's First and Last Name
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Up to 3 child siblings may be included on this form with prior approval from Gregory Grant.
Age of student
Required for children/teens classes
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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Phone Number
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-
Area Code
Phone Number
Emergency #
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-
Area Code
Phone Number
Class(es) or Workshops Registered for:
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Please include name of instructor
Total Tuition for Classes Registered for:
Starting Date :
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How do you wish to pay?
Check (payable to Academy for Emerging Artists)
Gift Certificate
Credit Card
Seat reservations are only guaranteed by paid tuition. No verbal reservations, please. Pre-registration is required to allow us adequate time for class preparation. Online credit card tuition payments are secure; we will also take cash or checks payable to: Academy for Emerging Artists. Mail to: Galerie Elan, 248 S Beach St., Daytona Beach, FL 32114. If paying with credit card, you will be directed to the online payments page after submitting this form. By electronically "signing" this form and clicking the "submit" button below, you verify that you have read, understand, and agree with the Academy of Emerging Artists CLASS POLICY.
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Type yes or no to indicate if you understand this.
The section below is for credit card payments only. Skip this section if paying with check!
For credit card payments only!
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Adult ongoing classes with Greg Grant, Channah Lohman
$125.00
$
125.00
4 classes for $125
Number of students
1
2
Children's ongoing classes with Greg Grant and Channah Lohman
$125.00
$
125.00
6 classes for $125
Number of students
1
2
3
Children's ongoing classes with Susanna Sparling
$150.00
$
150.00
6 classes for $150 (includes $25 supply fee)
Number of students
1
2
3
Total
$0.00
$
0.00
Credit Card
The Academy of Emerging Artists Class Policy
*
I have read, understand, and agree with The Academy of Emerging Artists class policy.
*
click here
I have verbally confirmed class availability with Gregory Grant.
*
click here
Signature
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Name of Adult Student, Parent, or Guardian
*
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