Forms

Student Enrollment Form

Students ages 7-17 may attend class without a parent or adult present, but Chelsea Art Center must have information on file for each student. The parent or adult who brings the student to class may stay if they wish, leave to visit shops at Chelsea Square Plaza, or leave if they wish, but they must return to the Art Center BEFORE the end of class to pick up their student ON TIME. Chelsea Art Center is not a day-care center or entertainment center.

Student Name *

First

Last

Student Age * Adult Name *

First

Last

Home Phone Cell Phone Email * Emergency Contact *

First

Last

Relationship to Student * Emergency Phone Number * If this student has any special needs, please explain what we need to know. *

Checkbox

I give permission for the student named above to be photographed or video recorded for the use of Chelsea Art Center.

Date *

Note: Once a student is enrolled at Chelsea Art Center you do NOT need to submit another enrollment form for future classes unless the information for this student has changed.

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