Student's Name *

First Name

Last Name

Date of birth

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent's Name

First Name

Last Name

Phone *

(###)

###

####

I have read the studio policies *

yes

I consent to my child's photo being used online, in newsletters, and for marketing purposes. *

yes