Summer Camp Form

BHCC Summer Arts Camp Application
In collaboration with OutLoud Dallas
The Bath House Cultural Center, in collaboration with OutLoud Dallas, is hosting BHCC Summer Arts Camp, a free camp for Dallas kids, June 13-July 1, 2022, Monday-Friday, 9-5pm.

Dallas youth between the ages of 11 - 14 will participate in a three-week visual and performing arts intensive that will culminate in a multidisciplinary public exhibition that will be shared with the community, friends and family.

521 E. Lawther Dr., Dallas, Texas 75218 • www.bathhousecultural.com

For questions about this application, contact Jessica Trevizo at jessica.trevizo@dallascityhall.com or 214-670-8722
For more information about this camp, visit https://bathhouse.dallasculture.org/22summercamps/

APPLICATION DEADLINE: Friday, May 27, 2022 (midnight Central Time).

The application must be filled out by a custodial parent or legal guardian.
Student Name *

First Name Middle Name Last Name
Age: *
Is your child eligible for free or reduced-price school meals?
School Name: *
Address *

Street Address

Street Address 2

City State / Province

Postal / Zip Code
Parent/Legal Guardian Name *

First Name Middle Name Last Name
Address *

Street Address

Street Address 2

City State / Province

Postal / Zip Code
E-mail *
example@example.com
Parent's Mobile Number *
Emergency Contact 1 *

First Name Last Name
Relationship to Student:
Phone Number *
Emergency Contact 2

First Name Last Name
Relationship to Student:
Phone Number
AGREEMENT

(Please read below before signing)

For more information about the BHCC Summer Arts Camp, visit https://bathhouse.dallasculture.org/21summercamps/

As a parent or legal guardian of a student attending the Bath House Cultural Center's Summer Camps, I agree to the following:
- I understand that attendance of the camp is mandatory. If my child misses more than two days of class, he/she will be withdrawn from the program.
- I will be responsible for the transportation of my child to and from the camp venue. My child will be at the center from 9 AM to 5 PM and will be picked up no later than 5:30 PM. If I am unable to transport my child, I will make arrangements and notify staff.
- I authorize the camp organizers to use photographs and/or video of my child for educational and promotional purposes.
- I give permission to the organizers to take my child to local field trips with staff and instructors.
- I understand that my child is expected to behave in a respectful and proper way throughout the camp. I understand that if my child continually misbehaves or disrespects the camp organizers and teachers, I will be asked to remove my student from the program.
- I understand that the camp organizers will not accept my child into the camp unless I sign a waiver and/or liability release (available on the first day of camp). These documents will state that neither the cultural center, the City of Dallas, nor the camp organizers (OutLoud Dallas) will be held liable for injuries or damages that happen to my child while he/she is attending the camp.
- I understand that my involvement in this process is integral to the success of my child and the entire process of the camp. I will assist the camp organizers by working with my child on assignments, volunteering time (if possible), and being a champion for my child's success.
Signature *

Clear
If your child has permission to take public transportation to travel to and from the camp site, please sign below.
Signature

Clear
Student Questionnaire

Please have your child answer the following questions:
Why do you think the BHCC Summer Arts Camp is a program that you want to attend? *
What forms of visual/performing arts do you enjoy and why? *
Do you have any experience with visual or performing arts? If so, please tell us about those experiences (Note: Not having experience will not disqualify you). *
Is there anything else that you would like the camp instructors to know about you? *
Should be Empty:

BHCC Summer Arts Camp Application

In collaboration with OutLoud Dallas

Student Questionnaire