AcA Summer Art Camp Registration
Time to register for Summer Art Camps at AcA! One registration form per child please. Upon completion of one registration, you'll have the opportunity to register a another child.
Camper Information
Child's Name
*
Nickname (if applicable)
Age
*
Birthdate
*
/
Month
/
Day
Year
Date
Grade level for following year
*
Dietary Restrictions and/or Allergies
Medical or other onditions we should be aware of
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact #1 Name
*
Emergency Contact #1 Phone Number
*
Please enter a valid phone number.
Emergency Contact #2 Name
Emergency Contact #2 Phone Number
Please enter a valid phone number.
Emergency Contact #3 Name
Emergency Contact #3 Phone Number
Please enter a valid phone number.
Release and Waiver and Liability
By signing below, I acknowledge that I have read and agree to the Camp Guidelines, Waiver, and Release.
*
Camp Selection
Session 1 • June 1–5
Session 2 • June 8–12 (this camp can be paired with session 3 to make a full day camp).
Session 3 • June 8–12 (this camp can be paired with session 2 to make a full day camp).
Session 4a • June 15–19 **To register for the full week, select 4a-4e**
Session 4b • June 15–19 **To register for the full week, select 4a-4e**
Session 4c • June 15–19 **To register for the full week, select 4a-4e**
Session 4d • June 15–19 **To register for the full week, select 4a-4e**
Session 4e • June 15–19 **To register for the full week, select 4a-4e**
Session 5 • June 15–19
Session 6 • June 22-26
Session 7 • June 22-26
Session 8 • June 22-24
Session 9a • June 29-July 3 **To register for the full week, select 9a-9e**
Session 9b • June 29-July 3 **To register for the full week, select 9a-9e**
Session 9c • June 29-July 3 **To register for the full week, select 9a-9e**
Session 9d • June 29-July 3 **To register for the full week, select 9a-9e**
Session 9e • June 29-July 3 **To register for the full week, select 9a-9e**
Session 10a • June 29-July 3 **To register for the full week, select 10a-10e**
Session 10b • June 29-July 3 **To register for the full week, select 10a-10e**
Session 10c • June 29-July 3 **To register for the full week, select 10a-10e**
Session 10d • June 29-July 3 **To register for the full week, select 10a-10e**
Session 10e • June 29-July 3 **To register for the full week, select 10a-10e**
Session 11 • July 6-10
Session 12 • July 6-10
Session 13 • July 13-17
Session 14 • July 13-17
Session 15 • July 20-24
Total due
Are you a member?
*
Yes
No
Deposit Amount Due Today
Remaining Balance
Email Address of the individual who should receive remaining balance payment link
*
example@example.com
Remaining Balance copy
Member discount
Member balance due
Payment Information
prev
next
( X )
USD
Credit Card
Submit
Should be Empty: