Summer Art Camp Registration

Registration Form

Please fill out to the best of your ability. We need one submission per camper - we apologize in advance for the duplicate information you will receive in follow up of submission. If any questions or concerns arise, you can reach us at maxtivitycreativespace@gmail.com or 541-714-3443. We're looking forward to spending some of our summer days together this year!
Registrant Types*

Parent registering child(ren)Self-registeringOther
Parent, Guardian, or Self-Registrant Info
Full Name*

First NameLast Name
Email*
example@example.com
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Yes, please! Send me all the Maxtivity deets.
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
Emergency Contact Information
Emergency Contact*

First NameLast Name
Phone Number*

Area CodePhone Number

Camp Choice(s)
If the Camp you are interested in does not appear below, this could mean that we have filled up for that Camp. Please proceed with completing the registration form, leaving the Camp selection blank. Someone will follow up with you to inquire and add you to our waitlist.

Camp descriptions can be found on the Maxtivity pages:

Website Events

Facebook Events

When making your selection
- use the left hand checkbox
- select your Membership status*
This will show you the whole cost, but if that is a barrier please select "Scholarship" for Payment Method and we will work together to get you or your kids to Camp!

*Interested in becoming a Maxtivity Member?

Visit here for more information.
Summer 2021 - Camp Options
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Clay Bootcamp Daysfor Ages 7 to Teens > Aug 3rd & 10th > 9:30-Noon; Aug 16th & 17th > 1:30 - 4pm *Option to choose one session or more.
$35.00 Maxtivity Member
Item subtotal:$0.00



Painting & Printmaking *RESCHEDULED*for 9 - 12 year olds > July 6th - 9th > 1:30-4pm *We are now holding this Camp AUGUST 16th - 19th > 1:30-4pm*
$120.00 Maxtivity Member
Item subtotal:$0.00



Product Name
$ Free



Total

$0.00
Payment Options

More info will be sent to your e-mail based on your selection.
Type of Payment*

Credit Card - Pay online thru SquareCash/Check - Send to: 1604 Main St Philomath, OR 97370Scholarship
Should be Empty:

Registration Form