Please fill out and submit the online form below to inquire about class availability. Alissa Popken, Education Curator, will be in touch with you shortly to receive class payment and confirmation. For immediate class registration, please download a PDF of the registration form and return it to the Emerson with your payment.


Download Registration Form


Date*:
YYYY-MM-DD format (e.g. 2013-04-08)

Student Name*:

Student Age (if child or youth):

Guardian Name (if child or youth):

Allergies or health issues we should know about?


CONTACT INFORMATION

(must be a number that can be reached during class hours)

Primary Phone*:

Secondary Phone:

Mailing Address*:

City*:

State*:

Zip*:

Email*:

How did you hear about us?*
WebsiteAdsClass InstructorOther

If Other, please specify:


CLASS INFORMATION

1. Class Title*:

Dates*:

Tuition*:


2. Class Title:

Dates:

Tuition:


3. Class Title:

Dates:

Tuition: