Artworks Teen Camp Registration Form
		 Students Information 
		
		
		1st Campers Name(s):      DOB: Name of school Attending:

		
		Select Camp Week(s):

		 June 21-25 June 28--July2 July 5-9 
		
		Select Lunch(s):

		 Lunch Monday Lunch TuesdayLunch  Wednesday Lunch ThursdayLunch  Friday
		
		
		
		
		Select Extended Day(s):

		 Monday Tuesday Wednesday Thursday Friday
		

		
		2nd Campers Name(s):      DOB: Name of school Attending:

		
		
		Select Camp Week(s):

		 June 21-25 June 28--July2 July 5-9
		
		Select Lunch(s):

		Lunch  Monday Lunch TuesdayLunch  WednesdayLunch ThursdayLunch Friday
		
		
		
		Select Extended Day(s):

		 Monday Tuesday Wednesday Thursday Friday
		

		
		3rd Campers Name(s):      DOB: Name of school Attending:

		
		Select Camp Week(s):

		 June 21-25 June 28--July2 July 5-9 
		
		Select Lunch(s):

		Lunch Monday Lunch Tuesday Lunch WednesdayLunch ThursdayLunch Friday
		
		
		
		Select Extended Day(s):

		 Monday Tuesday Wednesday Thursday Friday
		

		
		
Parents Information
		
		 
		Parent/Guardian(1)(Required):     

		
		Cell Phone:                    Email(Required): 

		
		
		
		
		Parent/Guardian(2)(Required):    

		
		Cell Phone:                    Email: 

			
		 
		 
		
		
		
		
		
PLEASE NOTE
		
		By submitting this form I indicate that I have read and agree to the registration, tuition and fees. No adjustments will be made for camper absences. 
		
		Although every effort is made to provide a safe environment accidents can occur. 
		
		
		I agree to be responsible for any medical bills incurred resulting from illness or injury during my child’s participation at Artworks. 
		
		If necessary, I authorize Artworks to administer first aid and/or authorize medical treatment of my child.

		
		
Additional Information:(special needs, or any requests)