Class Registration Form

Date____________

Student Name_________________________________________________________________________

Parent Name(if student is under 18)_______________________________________________________

Address______________________________________________________________________________

_____________________________________________________________________________________

Email_________________________________________________________________________________

Phone________________________________________________________________________________

Class__________________________________________________Month_________________________

Emergency Contact___________________________________________________________________

Phone________________________________________________________________________________

Make checks payable to Sage Garden Studios

Mail registration and payment to

Destiny Green- 240 South St. Douglas, Ma 01516

508.341.7252 destiny@sagegardenstudios.com www.sagegardenstudios.com