Summer 2017 Children’s Art Camp Registration Form

CampPicture2016_CROP

CAMPS 2017INSTRUCTORS | DAILY ROUTINE | ADDITIONAL INFORMATION | 

Registration Form | Summer 2017 Children's Art Camps
Please fill out the form below completely. Once registration form has been submitted, please secure your child's space at camp with payment via Square Invoice OR check.

Have questions or need assistance? Contact Shonna at (919) 754-8452 or info@rebusworks.us.

* Required
Child's Info
Please tell us a little about your child.
Child's Name - First and Last *
Your answer
Child's Age - *
Your answer
Special Concerns - Please list any special concerns you have regarding your child's camp participation (e.g. diet restrictions, allergies/sensitivities, educational needs) *
Your answer
Parent's Info
Please provide information on how we may contact you.
Parent's Name - First and Last Name of Parent / Legal Guardian *
Your answer
Parent's Phone Number (Primary Contact) *
Your answer
Email Address (Primary Contact) *
Your answer
2nd Parent's Name - First and Last Name of 2nd Parent / Secondary Contact *
Your answer
Phone Number (Secondary Contact) *
Your answer
Street Address *
Your answer
Apt #
Your answer
City *
Your answer
As the child's parent or legal guardian, do we have your permission to take photographs during class that may include your child? Rebus Works will use images from the classes to promote future classes on its website and in social media. *
Required
Emergency Contact Information
Name | Emergency Contact *
Your answer
Phone Number | Emergency Contact *
Your answer
Camp Courses: Please indicate which camp(s) your child will attend
This Summer Rebus Works is Hosting 8 Week-Long Art Camps for Children Ages 7 – 9 and 10 – 13!
Camps *
Yes $200 (July 4-7 Camp: $160)
No
June 19-23 - Elizabeth Galecke - 10-13 / Incredible Edible Art
June 26-30 - Jill Huffman - 7-9 / Summer of Love
July 3-7 - Anne Courie Menlink - 10-13 / advanced batik (taking July 4th off)!
July 10-14 - Cynthia McMorris - 7-9 / Exploring Art from Around the World
July 17-21- Cynthia McMorris - 10-13 / Urban Sketch and Plein Air Painting
July 24-28- Karen Rose - 7-9 / Painting with Mrs. Rose
July 31-Aug 4- Jill Huffman - 10-13 / The Chicken or the Egg?
Aug 7-11- Janet Masoura - 7-9 / Dimensional Visual Design Camp
Yes $200 (July 4-7 Camp: $160)
No
June 19-23 - Elizabeth Galecke - 10-13 / Incredible Edible Art
June 26-30 - Jill Huffman - 7-9 / Summer of Love
July 3-7 - Anne Courie Menlink - 10-13 / advanced batik (taking July 4th off)!
July 10-14 - Cynthia McMorris - 7-9 / Exploring Art from Around the World
July 17-21- Cynthia McMorris - 10-13 / Urban Sketch and Plein Air Painting
July 24-28- Karen Rose - 7-9 / Painting with Mrs. Rose
July 31-Aug 4- Jill Huffman - 10-13 / The Chicken or the Egg?
Aug 7-11- Janet Masoura - 7-9 / Dimensional Visual Design Camp
Will you need option for late pick up? 4-5pm *
Required
We will send you a Square Invoice and you can either pay online or send a check. Please add email address for payment. *
Your answer
Would You Like to Join Our Mailing Lists?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms