EmailMe Form - LVW Creative Barracks Manga Art Course

Name

First Last

Age

Has the artist attended camps, courses or classes with us before?

Yes

No

Does the artist have any known allergies?

Yes

No

Please specify

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Name

First Last

Relationship

Phone

### - ### - ####

Email

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Tuition Payment Options
Please specify how you would like to pay the $200 tuition fee. Payment must be received in order to complete registration. We offer a one week (7 day) grace period from time of registration to allow for payment delivery while still guaranteeing the student's place in the course.
Payment is accepted by e-transfer to barracksbythegrand@gmail.com
Mail or hand-deliver cash or cheque to
125 Queen St. Dunnville, in a sealed and labelled envelope.
If we are not open, payment may be left in the secure mail slot in the door.
Please specify payment below.