REGISTRATION FORM

        Complete the form below and return to the Bicentennial Art Center, 132 South Central Avenue, Paris, IL 61944, by mail or in person.  Payment must be made at the time of registration.  No registration is complete until all fees are paid.  Payment may be made in cash or by check made payable to:  Paris Art Center.  Registration forms must include the signature of the parent or guardian.  For more information, call the Art Center at 217-466-8130 between 10:00 a.m. and 2:00 p.m., Tuesday through Friday, or contact the Art Center by e-mail at susans@parisartcenter.com.  Please have your child wear old clothes or bring a paint shirt so that they do not ruin their clothes.

Name:  _______________________________________   Age:  ____________ 

Address:  _______________________________________________________ 

City:  __________________________  State:  __________  Zip:  __________ 

Daytime Phone:  ____________________  e-mail:  ____________________ 

Parent or Guardian Signature:  ___________________________________ 

Allergies or other conditions to be aware of:  _____________________

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Class Number   Title                                                                              Fee 

__________________________________________________________________ 

__________________________________________________________________ 

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                                                                               Total Fee:   $______________