3014 Hickory Blvd., Hudson, NC 28638
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Art Classes, Social Paint Parties, Birthday Parties & More

Lolli-Lu's Art Class Registration Form
Student Name:
Home Phone Number: 
Mobile Phone Number:
Mailing Address:
Email Address:
If UNDER 18 years of age, please complete the following:
Student's Age:
Current Grade:
Parent/Guardian Name:
Mobile Phone Number:
Emergency Contact Person:  
Phone Number: 
By completing the above, I release and agree not to sue Lolli-Lu’s, employees or affiliates from all present and future claims that may be made by the participant, me, my family, estate, heirs, or assigns for property damage, personal injury, or death arising from participation in Lolli-Lu’s programs or activities. I am the participant or parent/guardian of the participant, and I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I give permission to Lolli-Lu’s to photograph, video and/or record myself or my child for promotional and/or advertising purposes. I am also taking on full responsibility for all financial obligations associated with the programs listed above. ALL CLASSES REQUIRE FULL PAYMENT AT TIME OF REGISTRATION. FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE. NO CREDITS WILL BE GIVEN FOR MISSED CLASSES, OR CHANGES OF CLASS. 

Are there any allergies or medical issues we should know about?
Signature of participant or parent/guardian:
Have you taken classes with us before?
How did you hear about Lolli-Lu's?
Names of siblings in your household attending Lolli-Lu's Art Classes:
***Lolli-Lu's requires a registration form for each child***