2016-17 GREEN ACRES ART CENTRE PROGRAM REGISTRATION FORM
Name of Member: __________________________ Program(s) Name/Time/Age Grp:_____________________________________
___ Mommy and Me with Ms. Alycia – $70/Session: ___Session 1 (Oct-Nov), ___ Session 2 (Jan-Feb), ___ Session
3(Mar-Apr) Pay for one session in full at registration and additional sessions with cheques postdated Jan 1, Mar 1.
___ Little Stars with Ms. Alycia - $315 (includes $250 dance + $65 costume). Option 1) Pay $315 at registration;
Option 2) Pay half at registration ($157.50) and the balance with 1 cheque postdated Jan 1 provided at registration;
Option 3) Pay $78.75 at registration and the balance with 3 cheques for $78.75 each, postdated Nov 1, Jan 1, Mar 1.
___ One 1-hour Class with Ms. Alycia - $340 (includes $275 dance + $65 costume). Option 1) Pay $340 at
registration; Option 2) Pay half at registration ($170) and the balance with 1 cheque postdated Jan 1 provided at
registration; Option 3) Pay $85 at registration and the balance with 3 cheques for $85 each, postdated Nov 1, Jan 1,
Mar 1. Monthly payment options are available and can be arranged at registration.
___ Two 1-hour Classes with Ms. Alycia - $630 (includes $500 dance + $130 costume). Option 1) Pay $630 at
registration; Option 2) Pay half at registration ($315) and balance with 1 cheque postdated Jan 1 provided at
registration; Option 3) Pay $157.50 at registration and balance with 3 cheques for $157.50 each, postdated Nov 1,
Jan 1, Mar 1. Monthly payment options are available and can be arranged at registration.
___One 1.5-hour Class with Ms. Alycia - $505 (includes $375 dance + $130 costume). Option 1) Pay $505 at
registration; Option 2) Pay half at registration ($252.50) and balance with 1 cheque postdated Jan 1 provided at
registration; Option 3) Pay $126.25 at registration and balance with 3 cheques for $126.25 each, postdated Nov 1,
Jan 1, Mar 1. Monthly payment options are available and can be arranged at registration.
___Two 1.5-hour Classes with Ms. Alycia - $960 (includes $700 dance fee + $260 costume fees)
Option 1) Pay $960 at registration; Option 2) Pay half at registration ($480) and the balance with 1 cheque postdated
Jan 1 provided at registration; Option 3) Pay $240 at registration and the balance with 3 cheques for $240 each
postdated Nov 1, Jan 1 and Mar 1. Option 4) Pay $120 monthly Sept - Apr.
___ Highland New Beginner $260 ___ Returning Beginner $260 ___ Returning Intermediate $260___
Option 1) Pay $260 at registration; Option 2) Pay $130 at registration & $130 with cheque postdated Dec 13
provided at registration. Costume info will be provided by Miss Lesley.
___ Irish Dance – $325 Option 1) Pay in full at registration; Option 2) Pay half at registration ($162.50) and the
balance with 1 postdated cheque provided at registration, dated Jan 1; Option 3) Pay $81.25 at registration and the
balance with 3 postdated cheques provided at registration of $81.25 each, dated Nov 1, Jan 1 and Mar 1. Parents can
expect an additional $100 costume fee (not including shoes and wigs). Costume info will be provided at class.
___Guitar, Bass, Drums with Shane - $264/session, Option 1) Pay in full at registration; Option 2) Pay $88 at
registration and the balance with 2 post-dated cheques provided at registration for $88 each, dated October 30 and
November 27. Additional fee required for music booklets, to be arranged for with Shane. Indicate preferred lesson
time between 10am and 1pm Sunday ____________ Final time slot will be confirmed.
___ Piano with Ashley - $216/session, Option 1) Pay in full at registration; Option 2) Pay $72 at registration and the
balance with 2 post-dated cheques provided at registration for $72 each, dated October 17 and November 28.
Additional fee required for booklets to be paid directly to Ashley. To determine booklet needed, indicate if student
has taken lessons before and level achieved ______________________________________________________________________.
Indicate preferred lesson time starting at 4pm Monday ____________ Final time slot will be confirmed.
___ Adult Painting $130 ___ Adult Drawing $65 ___ $30 Supply Fee (for new students needing supplies)
___ Creative Drama Gr K-3 ___ Junior Acting Gr 4-6 – $200 due at registration or two installment plan available.
___Early Music for Pre-Schoolers ___Music for Children with Disabilities ___Fiddle – $135 due at registration.
Violin ___$350 for 1/2 hour 10 week session ___$375 for 45 min 10 week session ___$400 for 1-hr 10 week session.
Pay in full at registration or make 3 payments to be arranged for at registration. Additional fee required for music
booklets, to be arranged for with the instructor. Indicate preferred lesson time between 11:15am and 1:15pm
Sunday ____. Final time slot will be confirmed.
____ $25.00 Individual or ____ $50.00 GAAC Membership to be added to program fees and paid at registration.
Indicate amount paid at registration: _________________________ Indicate cheque # or paid cash ___________________
Provide postdated cheque #(s) & amount(s): _____________________________________________________________________