ACTion Drummers Mini Summer Session

This summer, ACT will offer a four week drum troupe opportunity for adults ages 16 and up! This program is designed for people interested in learning new things about drumming and increasing their skill level, performing in various community locations, being ACT ambassadors and having fun!
Artists Creating Together is a nonprofit agency that brings the arts and art project to children, youth and adults with disabilities from West and Northern Michigan.

Sign-up Today!

Basic Class Information

Drum Troupe will meet on Mondays from 5:15-6:15pm Class begins July 22 and runs for 4 weeks, through August 12 The class will be capped at 12 people Cost is $30.00 for Drum Troupe Performances to be announced For students 16 and older

Contact Information
Programming Intern, Megan McCrary Phone: #616-885-5866 Email: actadmin@artistscreatingtogether.org Web: www.artistscreatingtogether.org Facebook: Search for Artists Creating Together

Registration Form: Part 1

Classes are capped at 15, so sign up today! And unfortunately,
if fewer than 5 people sign up for a class, it will be cancelled. Registration

Registration Form: Part 2

Payment Information
You may sign-up for individual classes or can buy them in packages for extra savings. **Scholarships are available on an as-needed basis. Questions? Contact
Katie at program@artistscreatingtogether.org or #885-5866.

Participants Name__________________________________________ Date of Birth_______________ Age ______ Guardian's Name___________________________________________ Address ___________________________________________________ City___________________________________ Zip ________________ Phone ___________ Email___________________________________ Emergency Contact Person ___________________________________ Emergency Contact Phone_____________________ Disability (please check all that apply) ____ LD ____ ASD* ____ CI ____ EI ____TBI ____ CP ____ DS ____ BLIND/VI ____ DEAF/HI ____ WHEELCHAIR ____ MULTI ____ OTHER (please list) __________________________ ____ ALLERGIES (PLEASE LIST) ________________________________ * Ask about scholarships for individuals with Autism Spectrum Disorder
Assistant ACT encourages participants to bring an assistant if necessary for meaningful participation in class. There is no cost for assistants. Please note that we will not provide art supplies for assistants as the purpose of the assistant is to help the participant, not to work on his or her own art project. Name of Assistant __________________________________________ Photo Release: 2013

Mini-Drum Session: Summer 2013 $30

PAYMENT INFORMATION Method of Payment: ___ Credit Card ___ Mastercard ___ VISA Billing Zip Code _________ Exp.______ Account # _______________________________________________ ___ Check (Please makes checks payable to ACT) ___ Cash Payment is enclosed ____ Yes ____ No Send form and payment to ACT: 1140 Monroe NW, Suite 4101; Grand Rapids, MI 49503

I grant Artists Creating Together permission to photograph me/ (if you are your own guardian) my student and the right to use, publish, reproduce and disseminate any photograph of me/my child or their artwork obtained in connection with the classes taken at ACT without payment compensation to me/my child. Signature _________________________________________________