Place

ARTS CAMP 2011     

REGISTRATION FORM

Please fill out completely and return with deposit or full payment for each registered camper.

CAMPER INFO

CHILD #1: Name/Gender/Age                CHILD #2: Name/Gender/Age                               

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Parent or Guardian Name                     Email Address

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Home Phone /Cell                         Emergency Contact/ Phone #

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Street Address       

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Special Needs – please note if your child has any food allergies or special or dietary needs

______________________________________________________________________

CHILD #1 (check appropriate)                   

WEEK #1:_______

WEEK #2:_______

WEEK #3:_______               

CHILD #2

WEEK #1:________

WEEK #2:________

WEEK #3:________

CAMP TUITION: $300/CHILD/WEEK

*10 % SIBLING DISCOUNT*

Deposit Enclosed - $100/child _______

Full Payment Enclosed_________

Please include camper’s name on check.

Thank you. We look forward to seeing your child at camp!