Salt Spring Arts Academy
2011/2012 Registration Form
fields with * must be completed for online submission

Directions:     1. Fill-out form     2. Submit form    3. Make payment arrangements     Thanks!
Student Name * :     Phone*:    
Guardian Name
if under 18)* :		     E-Mail *:   
Address*:
child's birthdate*:
Workshop / Course
Tuition:
1.
2.
3.
   
Total $
Mailbox at Salt Spring Books or regular mail:

Salt Spring Arts Academy
125 Margaret Avenue
Salt Spring Island, BC V8K 1H4
Special Needs/ Medical Alerts:
 

Photography Permission:
If you would NOT like your child photographed or filmed during the course, production or
public performances, please indicate below:

Permission NOT granted
 

 

Questions?   call Shelley      e-mail:  office@saltspringartsacademy.ca       phone:  (250) 537-4294