Print out the following form. To reserve a place in class,
please contact Jennie to be sure space is available in the class.

Please make checks payable to "Fantastical Forest" and place checks or
cash in an envelope with your child's name on it. Payment may be given to Jennie
Harriman during class or mailed to her at PO Box 15, Roxbury, VT 05669.


Name of child ____________________________________________________________

Date of birth _____________ Grade ________ School __________________________

Name(s) of parent(s)/guardian(s) _________________________________________

Address __________________________________________________________________

Town _________________________________ State ___________ Zip ________________

Home phone _____________ Work phone ______________ E-mail _______________

Emergency Contact Person __________________________ Phone _____________

Food or other allergies? _________________________________________________

In case of emergency, my child may receive emergency medical treatment.

________________________________(parent/guardian signature and date)

I give my permission for photos of my child making art to be put on Jennie Harriman's

website. ______________________________________________ (parent/guardian signature and date)

What creative activities does your child most enjoy? ___________________

__________________________________________________________________________

What are your child's favorite subjects, such as animals, space, flowers?

_________________________________________________________________


Class(es)   ______________________________

			______________________________

			______________________________



Fee                 $__________

Total Enclosed      $__________



For more information contact Jennie Harriman during the day at Little Tree 802-229-0485, 
the White River Craft Center at 728-8912, or evenings at home 802-485-5603 or 
write fantastical4est@aol.com