VSA Nevada Online Registration Request
This form is for online registration |
PRE-REGISTRATION REQUIRED FOR ALL WORKSHOPS/CAMPS
PLEASE SUBMIT A SEPARATE FORM FOR EACH PARTICIPANT AND EACH
WORKSHOP/CAMP.
VSA Nevada will contact you to confirm your request and
for your credit card information
Workshops/camps are limited in size and are offered on a 'first
come first served" basis. Students needing to withdraw from a
workshop or camp after registering may receive a tuition refund less $5 administrative
cost if VSA Nevada is notified 5 business days before
the first session. No refunds thereafter.
Scholarships
are available based on need. Download, print and send in scholarship
application with registration form. You will be contacted regarding
the status of your scholarship.
|
| Participant Full Name: |
|
|
|
Male |
Female |
|
| School: (REQUIRED for
children's workshops/camps) |
|
|
| Age: |
|
|
| Parent/Guardian: (REQUIRED for
children's workshops/camps) |
|
|
|
Check here to join email list, 2-3 emails monthly. |
| Email: |
|
|
| Daytime Phone: |
|
|
| Second Phone: |
|
|
| Billing Address: |
|
|
| City: |
|
|
| Zip: |
|
|
| Emergency Contact Name: (REQUIRED
for ALL workshops/camps) |
|
|
| Emergency Contact Phone: (REQUIRED
for ALL workshops/camps) |
|
|
| Are you a friend of VSAN? |
Yes
No |
Become a friend at $100+ level and receive a 10% discount on all
workshops & camps |
| PLEASE SUBMIT A SEPARATE FORM FOR EACH
PARTICIPANT AND EACH WORKSHOP/CAMP. |
| |
| Where did you hear about this program? |
|
Please avoid bringing any snacks containing nuts. |
By submitting this form, I agree to hold VSA Nevada, City
of Sparks, Washoe County School District, and the Directors of these programs, harmless
from all suits, claims, or demands of every kind and character arising
out of and in connection with this program. In case of accident or
illness, the fore mentioned/VSA Nevada has my permission to secure medical
attention as deemed necessary if unable to communicate with me immediately. I
hereby grant permission to VSA Nevada to utilize my or my
child's artwork, appearance, name, voice and likeness to help promote
VSA Nevada in any and all manner and media.
VSA NV programs are open to all
children and adults.
If you need a reasonable modification for a person with
a disability or allergy, please describe below.
|
|
|
|
|