Young Writers Studio Registration

Please read the information sheet before registering: Program Information (PDF)

"*" indicates required fields

Student Information

Please have a Parent / Adult Responsible for the Student complete the online Registration Form.
Student Name*
(Optional)
Which school do you attend?*
Which grade are you in?*
What hour do you have English class?*

Parent(s) / Adult(s) Responsible for Student

1. Parent/Adult Responsible for Student*
2. Parent/Adult Responsible for Student (optional)

What Days Will Your Student Attend?

Program Dates*
Select all days your Student will attend. The Program Runs Monthly on Tuesdays from 3:15-4:45pm.

Transportation

Transportation TO the Alden B. Dow Home and Studio*

Consent

Parent / Adult Responsible for Student, please complete this section.
I give permission to photograph the student and use images for publicity.*
I confirm my student will be picked up from the Alden B. Dow Home and Studio at 4:45 pm by one of the adults listed on this registration form.*
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