Registration Form

Children and Teen
Classes
 
 

                                                                   

                                            

VISUAL ARTS MISSISSAUGA REGISTRATION FORM FOR CHILDREN/TEEN CLASSES. 

Mail this form to: Visual Arts Mississauga
4170 Riverwood Park Lane
Mississauga, ON L5C 2S7 
Or Fax to: 905-277-4340
Date: _______________________ 		Are you a member of Visual Arts Mississauga?
  Yes ____             No  ____		 Become a member of Visual Arts Mississauga!
Annual child/teen membership costs $10.00 and runs from  
August 1 - July 31 the next year.

Note: If your child is 6 years old, proof of age must be
submitted with this form.
Name: ______________________________      Age:__
Address:   ______________________________     City:  __________________  Postal Code:_____
Home # _____________________    Bus. _____________________  Cell _______________ 

 
Code Class Level

    Day

 Start Date Time   Amount
             
 		                                                                                                         
     
 		                                           
     
 		                                          
Course fees must be paid in full at the time of registration. Method of payment:        
Cheque _______   (Make cheques payable to: Visual Arts Missississauga) Membership fee      
Visa #___________________________________________           Exp. _____/_____ TOTAL  
MasterCard # _____________________________________          Exp. _____/_____      
 

  

Thank you. Your registration will be processed and a confirmation receipt will be mailed to you.

 
               
               
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