2010 Programs at Point Loma Arts Academy

Registration Form

Point Loma Arts Academy Program Registration Form
1. Fill out the below form completely.
2. Submit the form online by clicking "Submit".
3. Mail a non-refundable deposit of $100 to:
Point Loma Art Academy
c/o 4468 Newport Avenue
San Diego, CA 92107
4. Registration is on a first-come-first-served basis

My child wants to register for the following program:

Child's Last Name Child's First Name

Birthday:

Gender : Grade in Fall :

Address

City S State Zip Code

Home Phone # Emergency Phone #

Parent's Last Name Parent's First Name

Email

Child's T-Shirt Size:

If it is really important your child may request to be placed with ONE other child. Requests will only be honored if both children request each other. This request must be in advance on this form only.

First and Last Name of child you are requesting

Payment Method:

Please remember that your registration is not complete until we receive yo ur $100 deposit. Once we have received your deposit, a space will be reserved. Thank you!

Note, If you have any questions please call Mary Keller, Director, at (619) 886-4377.