Summer Camp Detailed Registration Form

Summer Camp Registration
Camper Information
Camp Sessions

Natural Dyes & Textiles July 7-11, ages 8-12, 9a-3pMethow Musings Writing Camp July 21-25, ages 8-11, 9a-3pBeing a Part of It Writing Camp, July 28-Aug 1, ages 15-18, 9:30a-12:30pBeing a Part of It Writing Camp, July 28-Aug 1, ages 12-14, 1p-4pPrintmaking, August 4-8, ages 9-14, 9a-3p
Camper's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
All campers will be headed to Twisp park for their lunch hour, please let us know if your child will be partaking in the summer lunch program supported by Methow Valley School District

Summer lunch programHome lunch
Parent/Guardian Information
Name

First NameLast Name
Phone Number
E-mail
example@example.com
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Methow Arts Alliance during the selected camp/camps. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Methow Arts Alliance and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Methow Arts Alliance including all edcucators and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

I give permission for my child to receive emergency medical treatment if necessary.
Signature

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Photo & Media Release

I grant permission to Methow Arts Alliance to photograph and/or record my child during camp activities. These images may be used for promotional materials, including the website, brochures, and social media.
Signature

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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.
Date

MonthDayYear
Date
Signature

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To ensure evey child has the opportunity to attend art camp,

Methow Arts Alliance has scholarships available.
Would you like to apply for a scholarship?

Yes

Summer Camp Payment

Natural Dyes & Textiles

$250.00

Methow Musings Writing Camp

$250.00 Quantity

Being Part of It, 15-18 years old

$125.00 Quantity

Being Part of It, 12-14 years old

$125.00 Quantity

Printmaking

$250.00 Quantity

Total

$0.00

Credit Card

Should be Empty:

Summer Camp Registration

Camper Information

Credit Card