PARSIPPANY - STEAM WORKS STUDIO - Summer Camps 2018 Registration

PARSIPPANY- Summer Camp 2018 Registration

Make.. Create.. Innovate.. Every Child is Gifted..
PLEASE READ

Enroll for 7 week and save $150. Please call for COUPON code.

1. Please carefully check the Summer Camp 2018 PDF to choose the weeks of Camps.
2. PLEASE NOTE: There is a $50 non-refundable one time registration fee per camper.
3. 5% Sibling discount
4. Please make sure to click the Print Form button to print your final selections and retain it.
5. For Full Day campers be sure to pack a Healthy nut free lunch.
How many Campers are you registering?
Number of Campers
- Number of Camp Weeks for Camper One*
  How many weeks of Camps?
- Camper 1 Name*
  
  First NameLast Name
- Camper 1 Age*
- Camper One Special Medical Info or Food Allergies
  Describe if special requirement ex Uses EpiPen
- Camp Week 1 Options*
- Pick Week 1 Camp Dates*
- Camp Week 2 Options*
- Pick Week 2 Camp Dates*
- Camp Week 3 Options*
- Pick Week 3 Camp Dates*
- Camp Week 4 Options*
- Pick Week 4 Camp Dates*
- Camp Week 5 Options*
- Pick Week 5 Camp Dates*
- Camp Week 6 Options*
- Pick Week 6 Camp Dates*
- Camp Week 7 Options*
- Pick Week 7 Camp Dates*
- Number of Camp Weeks for Camper Two*
  How many weeks of Camps?
- Camper Two Name*
  
  First NameLast Name
- Camper Two Age*
- Camper Two Special Medical Info or Food Allergies
  Describe if special requirement ex Uses EpiPen
- Camp Week 1 Options*
- Pick Week 1 Camp Dates*
- Camp Week 2 Options*
- Pick Week 2 Camp Dates*
- Camp Week 3 Options*
- Pick Week 3 Camp Dates*
- Camp Week 4 Options*
- Pick Week 4 Camp Dates*
- Camp Week 5 Options*
- Pick Week 5 Camp Dates*
- Camp Week 6 Options*
- Pick Week 6 Camp Dates*
- Camp Week 7 Options*
- Pick Week 7 Camp Dates*
- Number of Camp Weeks for Camper Three*
  How many weeks of Camps?
- Camper Three Name*
  
  First NameLast Name
- Camper Three Age*
- Camper Three Special Medical Info or Food Allergies
  Describe if special requirement ex Uses EpiPen
- Camp Week 1 Options*
- Pick Week 1 Camp Dates*
- Camp Week 2 Options*
- Pick Week 2 Camp Dates*
- Camp Week 3 Options*
- Pick Week 3 Camp Dates*
- Camp Week 4 Options*
- Pick Week 4 Camp Dates*
- Camp Week 5 Options*
- Pick Week 5 Camp Dates*
- Camp Week 6 Options*
- Pick Week 6 Camp Dates*
- Camp Week 7 Options*
- Pick Week 7 Camp Dates*

Parent Name*

First NameLast Name
Parent E-mail*
Parent Cell Phone Number*
Release of Liability:

I hereby agree to be responsible for the conduct and actions of my child and release STEAM WORKS STUDIO and their employees/staff from any claims and demands that may occur during participation in classes which may arise from incidents/accidents involving my child, held on the premises of STEAM Works Studio, to the extent allowed by law.
Signature*

Clear
Permission for Release of Content:

For STEAM WORKS STUDIO publications, website, and social media including Facebook and Twitter, for participants in classes, camps, and activities, I hereby consent that my child’s image, and likeness, as shown in videos, photographs, film, and/or electronics images and/or audio recordings of my child’s voice many be used by STEAM WORKS STUDIO for purposes of event documentation, media coverage, and promotion, and are the sole property of STEAM WORKS STUDIO.
Signature*

Clear
Coupon Code
Override
Coupon Calculation
Total

Grand Total

USDTotal after all discounts and rebates

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

Should be Empty:

PARSIPPANY- Summer Camp 2018 Registration