Registration
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July 17th - July 21st! 9:00am - 12:00pm Join us for a fun filled week of all things "art" and summer fun! Wanting to stay all day?? Book the next camp during this same week and you can stay during the 12-12:30 lunch break with all of our teachers! See the Summer Handbook Here https://docs.google.com/document/d/1qpbvVvtLxTqM6HcAaR9fV5keVIoRtd9rGxysKFaMXM8/edit?usp=sharing
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Carpool
Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
Home Phone:
*
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
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NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
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Emergency Contact Info
*
Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
*
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
*
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
School:
*
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Primary Doctor:
*
Questions/Options:
What size T-shirt would be best for your dancer? (Some campers get a free camp t-shirt with early enrollment)
*
Additional Information:
Other Questions/Comments:
Credit Card Verification:
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