Online Enrollment Form
Please complete a form for each student.
Payment must be received before classes can be guaranteed.

Please submit payment to:
GA-EPH, 4937 Lighthouse Pointe, Acworth, GA 30101.

If you register by the deadline, you may deduct 5% from the class fees.
If you pay via paypal, please add 3% to your total to cover the paypal fee.


Include the Admin Fees:  $20 per session or $50 per year/per family.
Families must submit a Participation Agreement.

 

Enrollment Form

Parent Name:
Student Name:
Age:
Gender:		Female Male
Special Instructions/Special Needs:
Address
City, State Zip
Email Address:
Phone Number:
Emergency Contact:
Emergency Phone:
Session:		1 2 3 4
Admin Fee-Per Family: $20 per session or $50 per year
9:30-10:40
		Mixed Media Arts
		Spanish
		Knitting
		Writing Creative Fiction & Essays
		Chorus
		Ballet/Tap
Other Class (9:30):
10:45-11:55
		Expressing Words with Dictionaries and Art
		Fun with Chess
		Young Rembrandts Cartoon Drawing
		Scrapbooking
		Elements of Acting
Other Class (10:45):
12:30-1:40
		Eco Spirit (5+)
		Chemistry
		Young Rembrandts Pastels
		Piano
		Love of Birds
		LEGO Simple Machines
		Totally Technology-Spreadsheets
		Beginner Guitar
		Jazz/Hip Hop Dance
Other Class (12:30):
1:45-2:55
		Eco-Spirits (9+)
		Human Body
		Entrepreneurship
		Clay Animation
		Recorder
		Intermediate Guitar
		Fractions
		Hands on Science & Technology using LEGO
Other Class (1:45):
3:00-4:10
		Clay Adventures
		Drawing with Colored Pencils
		Hands-on Geometry with Zome Modeling
		Video Game Design
Other Class (3:00):
Approval to have personal information listed in directory:		YES NO
Approlval to have photos in yearbook:		YES NO
Payment Agreement:		Will mail payment Will pay via paypal (add 3%) Other
Comments: