Student(s) Name *

First Name

Last Name

Contact Name

(If different from student)

First Name

Last Name

Phone *

(###)

###

####

Heartland Student *

Yes

No

Heartland Students *

you acknowledge that a certificate of approval from your teacher is required before the first class starts.

Yes

I am not involved with Heartland

Photography & Video Use *

Will you allow the use of photography and video of the student to be used in social media and other print and digital marketing use?

Yes

No

Class Options *

Please make sure to read the details for each class under the "Classes" page before selecting your class option.

Single Class (Ages 8+, 1.5 hrs , $65.00 per session)

Session Class A (Ages 8-12, 1.5 hrs, $180.00 per month)

Session Class B (Ages 13+, 2 hrs, $180.00 per month)

Mommy & Me Singles (Ages 4+, 45 min, $55.00 per session)

Mommy & Me Package (Ages 4+, 45 min, $180.00 per month)

Kinder Pottery (Ages 5-7, 45 min, $60 per session)