Summer Camp Registration Form

Upon completion of the registration form, we will need to receive payment in order to hold your spot. Please mail or stop into the studio to give payment. If you would prefer to download the form and fill it out, click here.

Name of Student *
Name of Student
Date of Birth *
Date of Birth
Name of Parent/Guardian/Primary Contact: *
Name of Parent/Guardian/Primary Contact:
Mailing Address *
Mailing Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Best way to contact you? *
EMERGENCY CONTACTS (Please provide two additional people, different from the parent/guardian listed above, who would automatically be the first person we contact)
First Contact’s Name: *
First Contact’s Name:
Home Phone
Home Phone
Work/Cell Phone *
Work/Cell Phone
Second Contact’s Name: *
Second Contact’s Name:
Home Phone
Home Phone
Work/Cell Phone *
Work/Cell Phone
SAFETY INFORMATION (please list all known conditions so we can accommodate your camper’s needs)