Shutterbug Camp Registration Form

Shutterbug Camp Registration Form
Thank you for your interest in the Winter 2025 Shutterbug Camp for kids! We are so excited to be able to give kids the opportunity to learn a skill that will follow them throughout their lives. I cannot wait to these little shutterbugs grow and develop as little photographers!!

*This camp requires a DSLR camera & a 16 GB memory card (min)

Cost: $175

Length: 5 consecutive days, 2 hours each day

**2+ Special**

Buy One Get One $75 off

During this season of giving, lets give the gift of knowledge and skills that kids can take with them throughout their growing years and into their adult years.

*Offer only available through December 31, 2024!!

Use Code: BOGO75
Name of Camper*

First NameLast Name
Camper's Birthdate*

MonthDayYear
Date
Camper's Coming Grade Level
Please Select Camp

Tiny Shutterbugs (6-9 year olds)Shutterbug Champs (10-14 year olds)Shutterbug Explorers (Homeschoolers)
HEALTH INFORMATION

*Need if in the event of emergencies
HEALTH INSURANCE COMPANY:*
POLICY NUMBER (IF KNOWN):
PLEASE LIST ANY ALLERGIES, INCLUDING DRUGS, FOOD, INSECT, ETC. & WHAT TYPE OF REACTION TO EACH.*
LIST ANY AND ALL PAST AND CURRENT ILLNESSES THAT MAY CREATE PROBLEMS WHILE AT CAMP:*
DATE OF LAST TETANUS SHOT. PLEASE INDICATE IF UNKNOWN:*
LIST ANY MEDICATIONS THAT WILL BE TAKEN AT CAMP WITH DOSAGES AND TIMES TO BE TAKEN:*
Name of Parent/Guardian*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you the Emergency contact for this camper?*
Second emergency contact for camper*

First NameLast Name
Phone Number*
Please enter a valid phone number.
What experience, if any, does your child have with cameras or photography?

No experienceBeginnerIntermediateAdvanced
What type of camera does your child have access to? *This camp requires a DSLR camera & a 16 GB memory card (min)
How did you hear about Shutterbug Photography Camp? Please specify:
Are you interested in being a parent volunteer for this camp?*
**Don't forget to use Coupon Code: BOGO75 when purchasing *2* for campers

Buy 1 Get 1 50% off
T-shirt Size*

SmallMediumLargeXL
Comments or Inquiries
TO THE PARENT OR GUARDIAN; I, THE UNDERSIGNED, APPROVE THE CAMP APPLICATION AND EXPRESSLY WAIVE ANY AND ALL CLAIMS AGAINST KRISTEN RACHEL PHOTOGRAPHY, IT’S MANAGER, STAFF OR REPRESENTATIVES BECAUSE OF ANY INJURY OR DAMAGE THAT MAY BE INCURRED TO THE NAMED APPLICANT. I ALSO AUTHORIZE THE CAMP TO ACT IN THE BEST INTEREST OF EACH CAMPER IN THE EVENT OF A MEDICAL EMERGENCY.
Signature*

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My Products

Shutterbug CampThis camp will be for 5 days, 2 hours per day. It will be full of fun activities, learning about basic photography skills, the history of photography and so so much more!

$175.00 Quantity

DonationIf you’d like to make a donation to help another camper attend and enjoy this experience, please contribute here. You can donate in increments of $25, $50, or full amount

$ Free Donation incrementsQuantity

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Subtotal

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Tax

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Total

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Shutterbug Camp Registration Form

HEALTH INFORMATION

**Don't forget to use Coupon Code: BOGO75 when purchasing *2* for campers

Payment Methods

**Don't forget to use Coupon Code: BOGO75 when purchasing 2 for campers