Questions? Call 248-258-2900 or stop by Wonderworks Art Studio 2227 Cole St. Birmingham, MI 48009. We’re in the rail district.

REGISTRATION FORM send to: 2227 Cole St, Birmingham, 48009
(248) 258-2900

Last Name_______________________________ First Name___________________________________

Street Address________________________________ City/State/Zip_______________________________

Home Phone_______________________ Work Phone___________________ Cell Phone_____________________

E-mail Address____________________________________________________

Parent’s Name if Student is Under Age 18 _________________________________
Birthdate of student__________________

CLASS DATE FEE

CLASS DATE FEE

CLASS DATE FEE
MC/Visa # _______________________________________ Exp.Date_______________

Account Name ____________________________________________

Check # ___________________________

• A $50 deposit per camp with a check will hold your spot. Make checks out to Wonderworks Art Studio. The remainder balance will be due one month prior to camp start date. This can be paid by check, MC or Visa.
• All other classes should be paid in full at time of registration.
• Cancellations will be accepted up to five days before class/camp starts. Refunds will be issued minus a $5 processing fee. No refunds will be issued after a class starts. If Wonderworks Art Studio cancels a class due to low enrollment, a full refund will be issued.
• I Will be paying my balance by check______ MC/Visa____________
Wonderworks may charge my card one month prior to camp_____

Emergency Contact Card for ________________________

Parent/Guardian_____________________________Phone__________________________________

Parent/Guardian_____________________________Phone__________________________________

Emergency Phone____________________________________________________________________

Health or Food Concerns______________________________________________________________

Insurance Carrier______________________________#_______________________

Hospital of Choice_____________________________________________________
I, ___________________authorize Wonderworks Art Studio and their employees to administer primary first aid for my child. I, ________________ also authorize the employees to seek emergency medical attention from medical professionals.
Signature of Parent/Guardian______________________________Date_________