Summer Camp Detailed Registration Form

Grand Arts Registration Form

Grand Love helping one arts at a time
Student Information
Name

First Name Last Name
Birth Date

Month Day Year
Grade
Gender

Male Female
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Grandparent/Guardian Information
Name

First Name Last Name
Home Number
Cell Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First Name Last Name
Relationship
Phone Number
Alt. Phone Number
Which art program are you applying for

Dance Music Theater Painting Drawing
Document request

1. Driver Lic
2. Pay stub or any form of income (Disability, Social Security, Unemployment, Child Support TANF)
3. Documents showing you are the guardian of your grandchild (Award letter, cps forms)

Once we receive the information we will start the process. Our committee meets every Monday and will make calls on Tuesday. Please know it can take up to 10 business days. If you have any questions or concerns please feel free to contact us.

Email all documents to
Info.grandlove@gmail.com
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

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Grand Arts Registration Form