Summer Art Camp Application Form

Summer Art Camp Application
Name
First NameMiddle NameLast Name
Date of Birth
MonthDayYear
Date
Gender
MaleFemale
Email
example@example.com
Phone Number
Mobile Phone Number
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Camper T-shirt size (shirts are in adult sizes)
XXSXSSMLXLXXLXXXL
Camp Session
Art Camp 1: Beginners Camp - June 15-19Art Camp 2: Intermediate Camp - June 22-26Art Camp 3: Advanced Camp - June 29-July 3

Medical Information
Does the camper have allergies including asthma?
Please explain on the field provided including any food the camper is allergic to
Is the camper currently under medication?
Please provide the details, the name of the medication and period of intake

Payment
The amount that appears below is the total amount payable to the camp. You may submit your payment on the first day of the camp session.
Total amount
I would like to pay
prevnext( X )
USDDescription
Should be Empty:

Summer Art Camp Application