AcA Summer Art Camp Registration
Time to register for Summer Art Camps at AcA!
all the things we need to say can go here
Parent/Guardian Contact & Emergency Contact Information
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact #1 Name
*
Emergency Contact #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2 Name
Emergency Contact #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #3 Name
Emergency Contact #3 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Name
*
Nickname (if applicable)
Age
*
Birthdate
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Grade level for following year
*
Dietary Restrictions and/or Allergies
Medical or other conditions we should be aware of
Release and Waiver and Liability
By signing below, I acknowledge that I have read and agree to the Camp Guidelines, Waiver, and Photo Release.
*
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Camp Selection
Have a waitlist code? Enter it here:
Camp Selection Child #1
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
Camps Selected
Total Due
Subtotal
Discount Amount
Coupon Code (if applicable)
Are you a member of the AcA at the Family Level or above? If you're unsure of your membership status, email our Development Manager Allison at allison@acadianacenterforthearts.org before submitting your registration form!
*
Yes
No
Deposit Amount Due Today
Remaining Balance (Non-Member)
Email Address of the individual who should receive remaining balance payment link
*
example@example.com
Member Balance
Deposit carry over
Remaining Balance #2
Payment Information
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( X )
USD
Credit Card
Should be Empty: