Name Birthdate dd/mm/yy Guardian Address Authorized Pick-up       City Postal Code Home Phone Cell/Work Phone Emergency Contact     Emergency Phone     E-mail     Allergies or special needs Desired Week Course Name zMini-MiniArt - Fall Termz     Day/time of classes Thursdays, 9:30-10:15am or 10:30 - 11:15am     Course Fee $275.00     Materials Fee included     Total Cost $275.00