SummerCamp-Registration-2022

Instructions

1. Please review ALL the registration information in the Camp Registration Guide (download HERE).

2. Complete this registration form. Only one form needs to be completed per family or group.

3. Read & sign: Code of Conduct; Release of Liability & Media Release Wiaver

Registration is limited to 15 students for the week. When spots are full, this form will no longer be available.

If have questions or if you need to change any information after you sign up, please contact Arts for All.
Email: info@artsforallnmi.org
Office number: 231-947-1278
Your Information

Please enter the information of the person responsible for the camp attendee(s).
First Name(s) of person/people responsible (Parent, guardian, assistant, etc.)*
Please write the first name of the person responsible for the attendee(s).
Last Name(s) of person responsible (Parent, guardian, assistant, etc.)*
Please write the last name of the person responsible for the attendee(s).
Email *
example@example.com
Would you like to receive our newsletters by email?

Yes please!No thank you.I already receive your emails.
Would you like to receive our newsletters by email?

Yes, please!
How did you hear about this event? (Check all that apply.)*

Arts for All's e-newsletterArts for All's website, artsforallnmi.orgFacebookInstagramNorthern ExpressThe TickerTC Record Eagleradio (Please share which station in the space below.)Friend or family (optional: Please tell us who in the space below.)Printed flyer or ad (Please share where in the space below.)Other
(Optional) If you have more details to share, please tell us:
Please share where you heard about this event.
Phone Number*
Please enter your phone number, starting with the area code.
Emergency Contact Phone Number*
Please provide a phone number of an emergency contact other than the participant.
Full Name of Emergency Contact*

First NameLast Name
Relationship of Emergency Contact to Participant(s)*
Example: Mother, Father, Assistant, Caregiver, Grandparent, Significant Other, etc.
Participant Address*

Street Address

Street Address - Apartment/Unit Number, etc.

CityState / Province

Postal / Zip Code
Participant Details

Please add information about all the participants who will be registering for camp.

Names & Details of All Camp Participants*

	First Name	Last Name	Age	Free T-Shirt Size (For registrations BEFORE June 8th ONLY)
1
2
3
4
5
6
7
8
9
10

Please list for each participant: 1. Known allergies or medical conditions. 2. Name and contact phone number of preferred doctor. (If none, write "none".)*
(optional) So that we can assure an environment as inclusive and accessible as possible, is there anything we should know about the attendees in advance?
The following forms MUST be signed and uploaded below.

OR email them to: info@artsforallnmi.org
OR drop them off at Arts for All during business hours (call ahead: 231-947-1278).
OR mail to:
Arts for All of Northern Michigan
1485 Barlow Street
Traverse City, MI 49686
1. "Participant Waiver and Release of Liability"
2. "Authorization of Media Publication Release"
3. "Summer Camp Code of Conduct"
Acceptable file types: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, jpg, jpeg, png, gif

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Arts for All of Northern Michigan (AFA) creates and updates promotional materials each year to help share our story about the many wonderful adaptive art experiences we provide to our community. These brochures, handouts, videos and invitations are important promotional tools for fundraising and fostering community awareness and support. AFA is a local non-profit organization whose mission is to provide people with disabilities residing in the Grand Traverse region with interactive experiences, both artistic and cultural. Please visit our website for additional information at www.artsforallnmi.org. Programs are designed to be accessible for all abilities, but not limited to those with disabilities.

MEDIA AUTHORIZATION RELEASE OF PHOTOGRAPHY, VIDEOTAPING, AND WEBSITE PUBLICATION

Arts for All respectfully seeks your permission to photograph and videotape you and/or your participant ONLY for the appropriate, approved purposes. Names will not be used. The images may be used for printed pieces, videos and online purposes - appropriately and tactfully - to represent the variety of adaptive art and cultural programs AFA provides.
I have read and I agree to the Media Authorization and Release. (Agreement is recommended but not required to attend.)
Please select Yes or No.
Payment

Please pay to complete the registration process.
Select how you prefer to pay. Your spot is reserved UPON PAYMENT. After our limit is reached, we can no longer reserve your spot unless you already paid.*

I am paying with a credit/debit card. I understand that my card will be charged today for the full amount. I have read and agree to the terms written in the "Eco-Art Adventures Garden Camp Cancellation Policy".Please contact me. I prefer to pay over the phone with a card, or pay with another method.Please contact me. I wish to apply for a scholarship to help pay for the summer camp.

Please pay by completing the information below. Registration is not complete without payment.

Registration for June 19th - 23rd, 2023 Product Image

Registration for June 19th - 23rd, 2023Registration is $175/person. Payable by check, cash, or credit/debit card.

$175.00 # of Happy Campers

YES! I wish to make a donation to Arts for All. Product Image

YES! I wish to make a donation to Arts for All.Check the box if you wish to make a donation. Your donations are tax-deductible. Donations are in increments of $1. Use the box to add your donation amount.

$1.00 $

Total

$0.00

Credit / Debit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Your Information

Participant Details

Payment