Creative Arts Studio – Summer Camp Registration

Please fill out the following form completely so that we can better understand your needs and respond accurately. If you need to register more than one child, please complete and submit this form once per each individual, separate child. Do NOT include more than one child's name below.

Upon receiving this information, we will review your selections and send an invoice indicating the total cost for the program based upon your selections below.

If your child is not enrolled in one of our Fall programs, there is a $25 registration fee (per family) that will be indicated on the invoice as well. Once we receive the information below, we will reserve a spot in our program for your child – although that spot is not guaranteed until we receive your payment.

IMPORTANT: If you do not provide a valid e-mail address, this form will NOT submit your information to us, even though you may receive the confirmation page.

Thank you.

All contact information in this first section below is required.

Child's Name:
Date of Birth:
Parent's Name:
Address:
City / State / Zip:	Select one... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Home Phone:
Cell/Work Phone:
E-mail Address:
Below, please select/check the weeks your child will be attending. You must select a minimum of 3 weeks. The week of June 30th does not constitute a camp week. Also, please select/check the days of the week that your child will be in attendance. You must select a minimum of 3 days, and they must be the same days for each week you selected.
Mon. Tues. Wed. Thurs. Fri. Week of June 23 Week of June 30 * C L O S E D Week of July 7 Week of July 14 Week of July 21 Week of July 28 Week of August 4 Week of August 11   * Not a camp week - KIDKARE ONLY. No minimum number of days required.
Our hours of operation are 7am – 6pm. Please indicate below your estimated drop-off and pick-up times that you would like to reserve. Mon. Tues. Wed. Thurs. Fri. Drop-off: Pick-up:
Questions/Comments?