Summer Art Camp Registration Form Camper's Information Camper's Name * First Name Last Name Age * Pronouns Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Guardian/ Parent's Information Guardian/ Parent's Name * First Name Last Name Guardian/ Parent's Phone * (###) ### #### Guardian/ Parent's Email * Emergency Contact Emergency Contact's Name * First Name Last Name Relationship to camper * Emergency Contact Phone * (###) ### #### Medical Information Allergies * Medication currently taking * Medical Conditions/ Special Needs * Artistic Experience Has your child participated in art classes or camps before? Yes No What type of art is your child interested in? Drawing Painting Photography Other Session Selection Please select the camp session(s) your child will attend: * Week 1 (7/7 - 7/10) Week 2 (7/14 - 7/17) Week 3 (7/21 - 7/24) Week 4 (7/28 - 7/31) Week 5 (8/4 - 8/7) Week 6 (8/11 - 8/14) Week 7 (8/18 - 7/22) Full Summer Camp Permissions and Agreements Photo Release: I grant permission for Just Art Summer Camp to photograph my child for promotional purposes * Yes No Medical Authorization: In the event of an emergency, I authorize the camp staff to seek necessary medical treatment for my child. * Yes No Additional Information How did you hear about Just Art Summer Camp? Any additional comments or concerns Thank you!
