Guardian Name * First Name Last Name Child's Name * First Name Last Name Child's Age * Child's Birthday MM DD YYYY Child's Sex Male Female Phone * (###) ### #### Email * Area of Interest * Creative Arts Camp Art Theater Intensive Chords 101 Intro to Harmony Voice Voice Plus (Select Guitar or Piano from List) Guitar Ukulele Bass Piano Drums Flute Independent Living Class Creative Hour Sewing Basics Tutoring Describe Current Skill Level Music Information First Time Beginner Intermediate Advanced Financial Assistance * Due to scholarship demand, we require proof of current assistance (WIC, Medicaid, EBT, Ect). Please do not hesitate to contact us, if you have questions. Email proof to thewillowproject44@gmail.com. Yes, I need assistance. No assistance needed Type of Current Assistance EBT WIC Medicaid Free Lunch Program Other None Assistance Description If you do not qualify through the options above, please provide a brief description of why you need assistance(Large family, loss of income, one income family, single parent, Ect.). Foster Child * Yes No Social Worker First Name Last Name Social Worker's Email Allergies Tutoring Needs Discribe child's area of need (Math, Reading, Ect.). Thank you for registering your child! We will contact you with more information! We can’t wait to see identity & creativity grow exponentially this semester! -The Willow Project
