Art Class with Stephanie at Stephanie’s REGISTRATION FORM

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* Parent/Guardian waives any claim for liability against Stephanie DiMuzio or Stephanie’s of Stone Harbor and expressly agrees to hold Stephanie’s of Stone Harbor harmless and indemnify its owners for any property damage or personal injury suffered by any party during the course of art class instructed by Stephanie DiMuzio at Stephanie’s of Stone Harbor.

*Payment & Cancellations I understand payment is due prior to scheduling for art class with Stephanie. I understand that there are no refunds for missed classes. A make up class can be re-scheduled within one week of a missed class.

Child's Name *

Child's Age & Grade *

Parent/Guardian's Name *

Email *

Phone number

* Photo Release I authorize Stephanie’s of Stone Harbor to use photos and videos of my child for whom I am a legal guardian for promotional purposes.

YES, I give permission

NO, I deny permission

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