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Scattered Seeds at New Life Glenside
Welcome to registration for Scattered Seeds + New Life Glenside's Artiful Camp (Summer 2022)!
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Student Name
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Grade
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Grade student will be entering in the 2022-2023 School Year.
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Choose A Camp
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Artiful Early Elementary Camp (August 1-5), Grades 1-3
Artiful Camp (August 1-5), Grades 4-10
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Artiful Early Elementary Camp (August 1-5), Grades 1-3
Artiful Camp (August 1-5), Grades 4-10
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Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
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Parent / Guardian Name
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First Name
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Parent / Guardian E-Mail
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Parent / Guardian Mobile Number
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8
Emergency Contact Name
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First Name
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9
Emergency Contact Phone Number
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10
Medical / Allergies
Describe any medical conditions (allergies, asthma, etc.), if medications need to be taken at camp and any instructions
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11
Medical & Liability Release
As the parent / guardian of the child named above, I give permission for him/her to fully participate in all activities in the Scattered Seeds / New Life Presbyterian Church of Glenside Artiful Camp. I recognize that the conditions and circumstances encountered during travel to and participation in activities may cause my child to be exposed to certain risks to health and personal property. I am allowing my child to participate in the activities with awareness of such risks. Further, I release New Life Presbyterian Church, Scattered Seeds, and its employees and agents from any claim of any kind whatsoever. In the event of a medical emergency, I give permission to New Life Presbyterian Church of Glenside, Scattered Seeds, its authorized employees and agents, to take my child to a doctor or hospital, and I authorize medical treatment and surgical procedures to be provided to my child, as necessary. I will be notified at the earliest possible opportunity of any medical treatments. I will assume responsibility for all medical bills incurred. In addition, if my child is required to return home for medical or disciplinary reasons, or otherwise, I will assume responsibility for any transportation costs, as well as for any property damages and expenses which may be incurred by my child while he/she is participating in activities sponsored by New Life Presbyterian Church of Glenside and Scattered Seeds.
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12
Photo Release Authorization
I grant permission for Scattered Seeds, Valley Christian School, and Huntingdon Valley Presbyterian Church to publish pictures and videos of my child for public publicity.
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13
Payment
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Online Cost: $175 + $7 (Processing Fee)
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Artiful Early Elementary (August 1-5, 9AM - 3PM)
For grades 1-3. Join us as we explore art together! We will use a variety of art mediums in both individual andcollaborative projects which may include drama, music, fine art, creative movement, and literacy-inspired art. | Online Cost: $175 + $7 (Processing Fee)
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Artiful Camp (August 1-5, 9AM - 3PM)
For grades 4-10. Join us as we explore art together! We will use a variety of art mediums in both individual and collaborative projects which may include drama, music, fine art, creative movement, and literacy-inspired art. | Online Cost: $175 + $7 (Processing Fee)
$
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