Registration Form–Theo Art School–June 20, 2015 in Mott, ND

Smile wide, get your hands dirty and make some art.
Smile wide, get your hands dirty and make some art.
flickertail theo
Each work of art is unique and individual even though students use the same step by step instructions. Come make art and turn your creativity loose.


Bring the bottom half of this form into the Mott Public Library with payment attached to secure your spot. Keep the top portion for your information. Class size is limited. Register Early.

Theo Art School

Mott Gallery of History and Art

And Mott Public Library Bring you


Fine art entertainment and instruction for the entire family.

June 20, 2015

All Supplies and Materials are included. 25 dollars per person per session Payment is due at Registration

Checks/Money Orders made out to City of Mott. Class Size is Limited

Adults, Families and Children                                                       21 and over

9:30-11:30                   1: 30-3:30                                                       5:30-7:30

Student One:  First________________ Last______________________________

Student Two:  First________________Last______________________________

Student Three: First_______________ Last______________________________

Student Four:  First________________Last______________________________

Student Five: First_________________Last______________________________

Student Six:    First_________________Last______________________________

Contact/Parent/Guardian: First_________________ Last____________________

Address: _____________City______________State____________Zip_________

Home Phone:_____________________ Cell Phone:___________________

Emergency Contact Info: Name __________________Number______________

Session:     9:30        1:30   5:30 (21 and over only)

  • Yes, I give permission to the Mott Public Library, Mott Gallery of History and Art and Theo Art School to use my photos, my children’s photos and photos of my/our artwork in publications and on websites of the above listed entities.

Amount attached:_________  Number of Students: _________

Contact Signature and Date:____________________________