Discovering New Media for Children 8 – 11 Registration Form

To sign up for Discovering New Media 8 – 11, please fill out the form below and click the Submit button. You will be taken to the payment page after you complete and submit this form. All fields are required.

Student's Name *

First

Last

Student's age *

Parent's Name *

First

Last

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Email *

Phone Number *

How did you hear about us?

I agree that my child's image may be used for duCret School of Art promotional material. I understand my child's name will not be used, but his/her image may appear in a duCret advertisement, brochure or internet marketing venue.

Choose one *

• Yes
• No

Submit