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Southern Enterprise School of Arts

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Performing & Language Arts

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Classes at 291 E. 222nd St., Euclid, Studio 258 * Required

Ballet/Interpretive Dance

Photography Class

Videography Class

Select one or both days * Required

Tues, 5pm-7pm

Sat. 2pm-5pm

Student's First Name

Student's Last Name

Date of Birth * required

Age

Sex * Required

Male

Female

Race * Required

Black

White

Hispanic

Other

Parent's FirstName

Parent's LastName

Parent's Cell

Parent's Email

Street Address

City

Region/State/Province

Postal / Zip code

Father's FirstName

Father's Cell Phone

Father's LastName

Father's Email

Grandmother's FirstName

Grandmother's LastName

Grandmother's Cell Phone

Grandmother's Email

Other Guardian FirstName

Other Guardian LastName

Other Guardian Cell Phone

I understand there are inherent risks associated with participation in Southern Enterprise School of Arts activities
By submitting this form, I grant permission for photos, video, and audio recordings to be used for promotional and educational purposes.

CONTACTUS Tel. 216-230-2835, Southern Enterprise School of Arts 291 E. 222nd St. Studio 257, Euclid, Ohio 44123

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