Fred Oldfield Western Heritage & Art Center Art Class Registration Form   Student Name (one per registration form): Year of Birth if under 18 Name of Responsible Party for child student (Must provide if above student is under 18 ): Address: City: State: Zip: E-Mail: Emergency Telephone: I am already a Fred Oldfield Western Heritage & Art Center Member     I already have the Art Class only Membership for this season       If you are not currently a FOWH&A member, you will need to purchase a membership with this registration. Art Class Memberships cover only the student and only for the classes for the season. With any of the other full memberships you can take advantage of Member Discounts for various Events, Gift Shop items, and Art Classes immediately. Just select the membership catagory you desire from the dropdown box below. No Discounts on memberships.   Membership desired: Please Select One from this list $10 - Individual Art Class Membership $20 - Senior (62+) $20 - Student (full time) $30 - Individual $45 - Family (2ind + kids under 18) $100 - Associate (4 ind) $1000+ Heritage Patron (3yr Family Membership) $2500+ Heritage Proctor (9 year Family Membership) $5000+ Heritage Partner (LIfetime Family Membership) If purchasing a membership, please enter the price of membership selected WITHOUT the dollar sign (This price will be added to this order)    $     Please list the names of the classes you are registering for: Cost of Class Please Select Class Desired from this list Mon 10:00 - 10:30am Students 4-6- $2.50- per class Mon 10:00 - 11:30am Students 11-17 years - $8.50 per class Mon 10:45 - 11:45am Students 7-10 years - $6 per class Tue 10:45 - 11:45am Students 7-10 years - $6 per class Tue 4:00 - 5:30pm Students 11-17 years - $8.50 per class Tue 4:30 - 5:30pm Students 7-10 years - $6 per class Tue 6:00 - 8:00pm Adult Students 18+ - $10.00 per class Wed 2:00 - 2:30pm Students 4-6- $2.50- per class Wed 2:00 - 3:30pm Students 11-17 years - $8.50 per class Wed 2:45 - 3:45pm Students 7-10 years - $6 per class Wed 4:00 - 5:00pm Students 7-10 years - $6 per class Wed 4:00 - 5:30pm Students 11-17 years - $8.50 per class Wed 6:00 - 8:00pm Adult Students 18+ - $10.00 per class First Sat of Month Adult Artists paint and visit! - FREE!(donations accepted!) $ I have a sibling registered. Name: Discount for 2nd, 3rd, child -10% $       Grand Total for this Registration: $   Credit Card Card you are using Visa MasterCard Card # Expiration Month and Year Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 2007 2008 2009 2010 2011 2012 2013 2014 2015   Please send your check or credit card information (MasterCard or Visa) to: The Fred Oldfield Western Heritage & Art Center P.O. Box 1539 • Puyallup, WA 98371   Please fill out the form and submit once.

The Fred Oldfield Western Heritage & Art Center is a Non-Profit 501 (c) (3) Corporation
All donations to this Center are Tax Deductable.
Your generous contribution will be instrumental in bringing bigger and better arts opportunities to the citizens of our region.