Summer Camp Registration Form

Dates: Monday-Friday, June 3-7, 2019

Time: 1:00 PM - 5:15 PM

Cost: $100 per student

Registration Deadline is May 30th!

Dates: Monday-Friday, June 15-19, 2019

Time: 9:00 AM - 12:30 PM

Cost: $100 per student

Registration Deadline is June 30th!

Children must be registered to attend. No prior skills necessary. Children should wear comfortable clothing that may get dirty and bring a snack each day. Scholarships may be available, contact The Plaza. Classes take place at The Plaza Community Center at 100 Ulysses Rice Ct., which is directly behind The Plaza Arts Center.

Please call with questions 706-923-1655.

Summer Camp Registration Form
Child's Name*

First NameLast Name
Child's Age*
Child's Grade (Fall 2019)*
School Attending*
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Email*
example@example.com
Does your child have allergies or special needs? If yes, please explain:*
Name of person (if different than parent) picking up child and their phone number:
Emergency Contact name and phone number(s):*
Summer Camps*
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Camp Broadway$100.00

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Art Camp$100.00

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