Summer Arts Camp Registration Form.Move & Groove

Summer Arts Camp Application
This summer ART Inc is offering a four-week camp designed for students in grades K-2, 3-5, and 6-8. This form is specifically for Move and Groove which takes place the week of June 28-July2.

The camp schedule is 100% yours to create the perfect summer based on your child's artistic interests and the session that best fits your schedule:

Morning Session: 9am-12pm
Afternoon Session: 1:30-4:30pm

Interested in enrolling your camper for Move and Groove? Please fill out the application form on the next page by pressing the next button below.

Personal Information of Camper
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Where does this student attend school? *
Gender *

Male Female
Student Grade (2021-2022 School Year) *

Choice of Week & Session
Registration Fees will be paid through PayPal and must be completed in order to complete the registration process online. YOU DO NOT need to have a PayPal account to use this system and may use a credit card or debit card. If you do not have a Paypal account you may sign in as a "guest".

Only one camper may be registered at a time.
Choose Your Camp!
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Move and Groove $ 150.00
Week 2: June 28-July 2 Cheer and Dance class for campers in K-2 Live performance Friday Night!

Grade of Camper Choose your schedule

Move and Groove (3rd-8th Graders) $ 150.00
Week 2: June 28-July 2 Dance and Music class for campers 3rd-8th grade Live performance Friday Night!

Grade of Camper Choose your schedule Class Option

Moove and Groove $ 150.00
Week 2: June 28-July 2 Cheer & Tumbling for 3-8 graders. Live performance Friday Night!

3rd-5th graders Cheer and Tumbling 6th-8th graders Cheer and Tumbling

Total $ 0.00
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Parental Information and Submission
Name of Parent

First Name Last Name
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
AUTHORIZED PICK-UP! Please list the First and Last Names of persons you give permission to pick up camper up.
Anyone picking-up a child must show valid ID and be listed as an approved individual at the time of pick-up
Please list any emergency contacts, their relationship to camper, best phone numbers or other contact information that will be helpful in an emergency.
I, hereby grant ART Inc Staff permission to authorize medical, dental, and/or hospital attention to your child. You understand that matters of any severity will be discussed as reasonably as possible after the initial incident. ART Inc and its staff cannot be held responsible for any repercussions caused as the result of treatment. I also grant permission for images of my child to be used for either Promotional Materials and/or Digital Camp Showcase. By granting permission, I am agreeing to:
- Promotional Materials – I hereby grant permission for images of my child, captured through video, photo, and digital camera, to be used solely for the purposes of educational and promotional material, publication in print, Discovery World's website, ART Inc's social media sites. I hereby wave
  my rights to inspect and approve the finished product or copy that may be used in connection with an image and of compensation or ownership thereto.
Electronic Signature: By entering my name below, I accept the above conditions and releases. (You must be 18 years old or over to sign below.) * *

First Name Last Name
Relationship to registered camper: *
Current date *

Month Day Year
Date
Should be Empty:

Summer Arts Camp Application

Personal Information of Camper

Choice of Week & Session

Parental Information and Submission