The Art Farm - Play Group Sign-Up Form

Play Group Sign-Up Form

To register, please fill out this form online, print, sign and date. Send this form along with a check paid in full to the address at the bottom of the form.

Child's Name:
Male Female Age: Birth Date:

Child's Name:
Male Female Age: Birth Date:

Name of Parent/Guardian:

Permanent Address:

City: State: Zip:

Email: (required)

Permanent. Home Phone: Cell Phone:

Emergency Phone: Summer Phone:

Class Choices	Start Date	# Days/ Week	Time	# of Weeks	Tuition
First Child:
Second Child:

Tuition:
	2 days a week	3 days a week	5 days a week
1 week	$110	$165	$275
2 weeks	$220	$330	$550
3 weeks	$330	$495	$825
4 weeks	$440	$660	$1100
5 weeks	$550	$825	$1375
6 weeks	$660	$990	$1650
7 weeks	$770	$1155	$1925
8 weeks	$880	$1320	$2200

For your information

There are no refunds given for any cancellations after May 31st.
There will be a $25 service fee applied to all changes.
There is a $25 fee for all cancellations before May 31st.
There is a $30 fee for all returned checks.
Please keep your child home if they appear to be getting sick.
Please deduct $55 from the total tuition if your are registering for week of June 30th
There is no Play Group on Friday, July 4th

I wish to enroll my child in the above session(s) with the understanding that I or my child’s caregiver is responsible for my child’s behavior in class and during animal time. This is crucial in order to maintain a fun, safe environment for both the children and the animals.

I have read and fully understand the above terms.
Parent's Signature: Date:

To register, please fill out this form online, print, sign and date. Send this form along with a check paid in full.

Make payable to:
The Art Farm • P.O. Box 1976 • Bridgehampton, NY 11932
Phone 631.537.1634 • Fax 631.537.2295 email: info@theartfarms.org