Bead Blast! 2012 Registration Form
Child's Name:______________________________________________________DOB:_______/______/______ Age:_________________
Address:________________________________________________City:_____________________State:______________ Zip:__________
School:_________________________________________________________________________Grade in Fall:_______________________
Email :_____________________________________________________________________________________________________________
Parent Name:______________________________________________________Home Phone:____________________________________
Parent Cell #:__________________________________________________Parent Work #:______________________________________
Emergency Contact Name:_________________________________________Home Phone:___________________________________
Emergency Contact Cell #:_________________________________________Relationship to child:_____________________________
Session times are from 10:00 am to 12:00 pm. Please check each session attending below:
2012 sessions will be posted in the new year.
The Fine Print:
*Pre-registration is required for all sessions. Full payment is due at time of registration.
*All participants must have a registration form on file before attendance. No exceptions.
*Refunds are not issued for a missed day. Please plan carefully. If your child is sick/absent on their scheduled day they may transfer to another session(space
permitting). Please be aware that projects differ in each session. A project kit will be prepared for the child to take home if space doesn't permit on another
date, or the child is too sick to attend.
*There are no refunds issued unless a session is cancelled. Sessions may be cancelled if less than 4 children are registered to attend. Participants will be given
24 hours notice when a session is cancelled. Participants may transfer into another session (space permitting) in lieu of a refund if their session is cancelled.
*Please respect prompt pick up and drop off times.
*Children are allowed to bring a water bottle labeled with their name and a light peanut free snack if they choose.
*Bella Beads reserves the right to dismiss any child from the program for inappropriate or unsafe behavior, language, or disrespect. No refunds will be given
due to dismissal, nor will the child be given a transfer date.
*By signing below, I release Bella Beads, LLC, it's members, and all employees/volunteers from liability of any accidents and/or injuries while participating in
the Bead Blast! Summer Program. Bella Beads always puts the safety of its' participants first!
ParentSignature:____________________________________________Date:_________________________
Please fill out payment info below (or mail form and call 978-474-4424 to register with a credit card!):
Total Fee Paid:_______________________Check#:________________Cash:_______________
Credit Card: MC or VISA Expiration Date:__________________________________
Name on Card:____________________________________________________________________
Card#:______________________________________________3 Digit Code on back:_________ Thank you!
Mail this form with payment to: 89 Main Street Andover, MA 01810
A cool place to "bead" yourself!
Child's Name:______________________________________________________DOB:_______/______/______ Age:_________________
Address:________________________________________________City:_____________________State:______________ Zip:__________
School:_________________________________________________________________________Grade in Fall:_______________________
Email :_____________________________________________________________________________________________________________
Parent Name:______________________________________________________Home Phone:____________________________________
Parent Cell #:__________________________________________________Parent Work #:______________________________________
Emergency Contact Name:_________________________________________Home Phone:___________________________________
Emergency Contact Cell #:_________________________________________Relationship to child:_____________________________
Session times are from 10:00 am to 12:00 pm. Please check each session attending below:
2012 sessions will be posted in the new year.
The Fine Print:
*Pre-registration is required for all sessions. Full payment is due at time of registration.
*All participants must have a registration form on file before attendance. No exceptions.
*Refunds are not issued for a missed day. Please plan carefully. If your child is sick/absent on their scheduled day they may transfer to another session(space
permitting). Please be aware that projects differ in each session. A project kit will be prepared for the child to take home if space doesn't permit on another
date, or the child is too sick to attend.
*There are no refunds issued unless a session is cancelled. Sessions may be cancelled if less than 4 children are registered to attend. Participants will be given
24 hours notice when a session is cancelled. Participants may transfer into another session (space permitting) in lieu of a refund if their session is cancelled.
*Please respect prompt pick up and drop off times.
*Children are allowed to bring a water bottle labeled with their name and a light peanut free snack if they choose.
*Bella Beads reserves the right to dismiss any child from the program for inappropriate or unsafe behavior, language, or disrespect. No refunds will be given
due to dismissal, nor will the child be given a transfer date.
*By signing below, I release Bella Beads, LLC, it's members, and all employees/volunteers from liability of any accidents and/or injuries while participating in
the Bead Blast! Summer Program. Bella Beads always puts the safety of its' participants first!
ParentSignature:____________________________________________Date:_________________________
Please fill out payment info below (or mail form and call 978-474-4424 to register with a credit card!):
Total Fee Paid:_______________________Check#:________________Cash:_______________
Credit Card: MC or VISA Expiration Date:__________________________________
Name on Card:____________________________________________________________________
Card#:______________________________________________3 Digit Code on back:_________ Thank you!
Mail this form with payment to: 89 Main Street Andover, MA 01810
A cool place to "bead" yourself!
