Student/Client Name *

First Name

Last Name

Student/Client Phone

(###)

###

####

Contact Name *

First Name

Last Name

Contact Phone *

(###)

###

####

By checking the box below I acknowledge that this is a request for services and not a completed registration. Once reviewed and approved a staff member will respond with completed registration information. *

I understand this is a request and registration is not confirmed until I receive a separate email with registration confirmation and invoice.

By checking the box below I acknowledge that if my service provider declines payment I am personally responsible to pay the full outstanding balance due to Strand Center for the Arts regardless of attendance. I understand and will abide by Strand Center for the Arts' refund policies. *

I understand and agree to pay the full invoice balance due to Strand Center for the Arts if my service provider declines payment and I understand the Strand Center for the Arts' refund policy.