Student Registration Form

Please NOTE: This web site is updated manually. As a result the class openings indicated on the Schedule page are not accurate from minute to minute. We will confirm placement as registrations are received and will update the web pages as quickly as possible. If you register for a class which has already filled we will contact you ASAP and provide information about alternative classes/days.

• The online form below will time/date stamp your registration request into a queue.
• This form is to be used by ALL STUDENTS for FALL 2010.
• PLEASE NOTE: Check or cash payment must be received within seven (7) days of registration. After seven days pending registrations may be canceled.
• To avoid passing credit card charges and transaction fees to our customers we do not accept credit card payments. Your checks or cash are welcome. Send payment to: ActonArt, P.O. BOX 2743, Acton, MA 01720 or you may deliver it to the studio.
• ALL FALL registrations must include a one-time-per-year, per FAMILY registration fee of $25.
• Please fill out a complete online form for each student you wish to register. Two or more students require two or more complete form submissions. Our database cannot process multiple students off a single form.
• Fields marked in RED ARE REQUIRED!

This form is now active. You may submit registrations any time.

Student First Name:
Student Last Name:
Gender:



Date of birth
(use format mm/dd/yyyy):
Class
choice 1
Class choice 2
Class choice 3
Parent/Guardian 1 First Name:
Parent/Guardian 1 Last Name:
Street Address:
City:
State:
ZIP:
Home phone:
Cell phone:
Email:
Parent/Guardian 2 First Name:
Parent/Guardian 2 Last Name:
Street Address:
City:
State:
ZIP:
Home phone:
Cell phone:
Email:
Emergency contact name:
Emergency phone:
Doctor name:
Doctor phone:
Allergies, etc:
How did you hear about ActonArt?
I have read and understand the 2010-11 ActonArt registration and enrollment policies and understand there are no refunds, credits or guaranteed make-ups for missed classes. THIS BOX MUST BE CHECKED!
I give permission for my child to receive medical attention in the event of an emergency
I give permission for my child's photograph to be displayed on ActonArt promotional media (without full name or other identification).
 
(form may process slowly)
If you wish to send us additional comments or information regarding your registration please email us at enroll@actonart.com. Please include your student's full name.