Manayunk Art Center Class Registration Form

Please print out the following form and mail with your check payable to "Manayunk Art Center".

Manayunk Art Center,
419 (rear) Green Lane,
Philadelphia PA 19128

Checks and registration forms must be received at least one week before the date of the first class to reserve space and to guarantee sufficient enrollment to proceed. Fees are non-refundable except that we reserve the right to cancel a class and refund all monies if not enough students register for that class.

Name of student: _______________________________________________________

Street Address: _________________________________________________________

City, State, Zip: __________________________________________________________

If child, name of parent: ___________________________________________________

Home Phone: _______________________ Work Phone: _______________________

Email: _____________________________________________

Class title (& session #) for which you are registering :

_____________________________________________________________________

Beginning date of first class :

____________________________________

Amount enclosed: $ ____________________