Lisa Zadravec (Rodriguez)
ART CLASS
REGISTRATION
(703)404-2977      info@lisarts.com
For mailing list or
artwork inquiries:
Your name:
Your email address:
Your phone number:
Mailing address & Interests:
Register online for classes at Lisa's home
* Required Field
Artist's NAME,
age/ grade:
*
EMAIL & PHONE #:
*
Parents names for
children & teen classes:
address:
Approved pick-up persons, emergency contact:
*
CLASS/CAMP TITLE, allergy/health/learning needs
TO REGISTER for Classes, Camps & Workshops     
at Claude Moore Rec Ctr go to www.loudoun.gov/claudemoore or call (571)258-3600
at Michaels Sterling go to
www.michaels. com or call (703)430-8645
at Stifel & Capra got to
www.stifelandcapra.com or call (703)533-3557

For Classes at the artist's home studio fill out the online form below. Payments are due
the first day of class.  I’ll be in touch with you to confirm your registration and follow
up with any additional info. Lisa Zadravec  703-404-2977

By registering as an art student or as parent/guardian of the student(s) named above, I give permission for her/him to participate in the class or summer
camp(s). I assume responsibility for all payments. I acknowledge that photos will be taken during the class, and may be used for advertising or promotional
materials for the instructors’ businesses.  I will instruct my child to adhere to all safety rules. I assume any risks involved in this kind of activity and
absolve the instructors, helpers from responsibility in the event of any loss, accident or injury to my child or his/her property. I accept responsibility for
any damages caused by my child. I further grant permission for emergency first aid to be given to this child and for her/him to be taken to the emergency
room in the event of a serious injury.  Permission is granted to the hospital and its staff to provide any treatment that the hospital physician deems
necessary for the well being of my child.