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A ministry of:

New Hope Christian Fellowship


292 Route 101, Bedford, NH 03110
603-345-7203
contact: SherylGoedecke@yahoo.com

www.SKETCHartProgram.blogspot.com
STUDENT NAME: AGE:



Parent/Guardian Name: ___________________________________________________________________

Address: _______________________________________________________________________________

City: __________________________________ State: ____________ Zip:____________

Home Phone:_______________________________ Cell Phone:_____________________________

Email: _________________________________________________________________________________

Please explain any medical problems, allergies, learning disabilities, etc. that we should be aware of on the
reverse side of the page:

A one time fee of $35 per family (not per student) is payable at time of registration
This is used to cover the cost of our community service projects, and printed materials.
Please note that this does not include art supplies.

Registration is accepted on a first-come, first-served basis. Payment should be made out to New
Hope Christian Fellowship and is due in full with this completed application before the first day of
class.

Waiver: As the legal parent or guardian, in consideration of New Hope Christian Fellowships acceptance of my enrollment, I release and
hold harmless New Hope Christian Fellowship, its staff and members from any and all liabilities, claims, demands and causes of action
whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the
undersigned, while in or upon the premises of New Hope Christian Fellowship.. I understand that New Hope Christian Fellowship
administrators have the right to dismiss any student at their discretion, and that I will not be entitled to a refund of tuition. I understand
that I am required to supervise my child/ren at all times. By signing this form, I acknowledge that I have read and understand the above
policies. This agreement is a legally binding instrument when signed by the registrant. I understand that the non-refundable tuition is due
in full with the completed application

Parent Signature: _______________________________________________ Date: ________________

Photo Release: SKETCH makes it a policy to avoid posting any pictures of childrens faces. Artwork, however, is regularly photographed
as an integral part of the course, and therefore the signing of a photo release is necessary for registration.

I grant full permission to New Hope Christian Fellowship to use any photographs or videos of art or classroom activities for community
service and promotional purposes.

Parent Signature: _______________________________________________ Date: ________________
2014/2015 Class
Registration
(Only 1 form per family please)

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