Registration - Bass Arts Studio

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Participant's Name

First

Last

Phone Number

Class, Camp or Workshop Selected

Date of Birth/Grade

if participant is less than 18 years of age

Parent Name

if participant less than 18.

Cell Phone #

Emergency Contact & phone #

Shipping Address

Address Line 2

City

State / Province / Region

Postal Code

Country

Payment Methods

Venmo
Check

payment should be made via Zelle (201-341-7714) or Check payable to Bass Arts Studio mailed to: 202 Park St. Montclair, NJ 07042

Tuition Amount Paid

Indemnity Clause

I/ we the parents of the above named child do hereby give my/our approval to participation in any and all of the activities. I/We do assume all risks and hazards incidental to the conduct of the activities and transportation to and from activities; and do further hereby release, absolve, indemnify and hold harmless Bass Arts Studio and the organizers and supervisors, any or all of them. In case of injury to my/our child, I/we hereby waive all claims against theorganizers, the sponsors or any supervisors appointed by them.

Photography Permissions

Bass Arts Studio has my permission to use photos of my child for publicity.

Comments & Concerns or special needs (allergies)

Confirmation

I acknowledge that I have read and agree to abide by the the Terms and Conditions
I acknowledge that upon submitting this form, my orders are final and can no longer be canceled