Teaching the Monart method since 1992                                                                                                              858.259.7154

After-School Program Release Form

____________________________

 

* School:

* Session:

* Student Name: * Age: * Grade:

* Primary Phone:  Secondary Phone:

* Email Address:

* After Class:

 

By typing my full name below I hereby consent for my child to attend Monart:

*

 

* (check one): PAYMENT MUST BE ARRANGED IN ORDER TO SECURE A SPOT

pay by check  (make checks payable to "Monart" for amount listed on flyer)

pay by credit card  (fill out card info below  or  call in your card with the office)

       Card #  Exp.  CVC (3 digits on back)

       Comments:

       * Required Fields                               

 

SORRY. WE DO NOT ACCEPT AMERICAN EXPRESS CARDS.