Short Registration Form


Name/s:____________________________________________________

___________________________________________________________

Age & grade/s:_____________________________________________

Name of guardian(s):_______________________________________

Address:___________________________________________________

___________________________________________________________

City: ________________________ Zip:________________________

Phones: Cell______________________Home_____________________

Work______________________Other___________________________

Email (please print clearly):______________________________


For more information and eligibility please call: 

423-320-6738

Classes will be at James A Henry Bldg. SPLASH Art Studio located at: 1200 Grove Street, Chattanooga, TN 37402 

Fill out application when you arrive or bring application with you at time of class.