Summer 2008 Online Registration Form
Use this form to request your class. Beck Center will contact you before the end of the next business day with a confirmation and to take your credit card order. You may also use the print/mail form [pdf].
Beck Center for the Arts.
Student's Name:
School:
Date of Birth: MM    DD    YYYY
Age:
Gender: Male     Female
Student Status: New Student    Returning Student
Address:
Apt. Number:
City:
State:
Zip:
E-Mail:
Responsible Party (for Payment):
Phone (Home):
          (Work/Cell):
How did you hear about classes at Beck Center? Friend   Yellow Pages   Web Site   Other
Are you familiar with our Professional Theater? Yes No   If no, and you would like to receive information
check here

CLASSES

Class Day Time Session Tuition Start Date

PRIVATE MUSIC LESSONS

Instrument Instructor Day Time Length(mins.) Wks. Tuition Start Date

To schedule Private Music Lessons, contact the Music Department at (216) 228-2800

ANNUAL PAYMENT SUMMARY
Registration Fee $15 Individual; $35 Family: $ Non-refundable. See registration information.
Tuition: $
Other Fee (if applicable): $
Donation (Your tax-deductible donation will help support the programs of The Beck Center for the Arts, a not-for-profit organization): $
Total Payment Due: $

Please check if you DO NOT want your child photographed or videotaped for any Beck Center or media use. If this line is not checked, you are agreeing to allow any photos or video obtained of your child while in classes at the Beck Center to be used in publication by the Beck Center or other media.

I UNDERSTAND THAT SUBMITTING THIS FORM IMPLIES AGREEMENT TO, AND OBSERVANCE OF, THE RULES AND REGULATIONS OF BECK CENTER AS PUT FORTH IN REGISTRATION POLICIES AND THIS REGISTRATION FORM.

   

Beck Center Registrar   17801 Detroit Avenue   Lakewood, Ohio 44107