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2014 ART CAMP REGISTRATION FORM

2014 ART CAMP REGISTRATION FORM

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Published by Ken Vail
Registration Form for Healthy Rhythm Community Art Gallery's 4th Annual Art Camp 1 & 2.

Art Camp is open to young folks 6 to 13 years of age.

Art Camp covers a variety of mediums, including drawing, painting, and mixed media.

Art Camp has an Opening Night exhibition of 4 to 6 pieces of each Campers artwork. Opening Night occurs 3 to 4 weeks after the school years starts. Each Campers artwork remains on display at the Gallery for 1 month.

The ultimate goal of Art Camp is FUN!

*Early registration is encouraged, as there are only 10 spaces available for each Art Camp.
Registration Form for Healthy Rhythm Community Art Gallery's 4th Annual Art Camp 1 & 2.

Art Camp is open to young folks 6 to 13 years of age.

Art Camp covers a variety of mediums, including drawing, painting, and mixed media.

Art Camp has an Opening Night exhibition of 4 to 6 pieces of each Campers artwork. Opening Night occurs 3 to 4 weeks after the school years starts. Each Campers artwork remains on display at the Gallery for 1 month.

The ultimate goal of Art Camp is FUN!

*Early registration is encouraged, as there are only 10 spaces available for each Art Camp.

More info:

Categories:Types, Brochures
Published by: Ken Vail on Apr 22, 2014
Copyright:Traditional Copyright: All rights reserved

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06/06/2014

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HEALTHY RHYTHM COMMUNITY ART GALLERY
4
th
 ANNUAL ART CAMP 
 
Registration Form
 
Camper’s Name
: ______________________________________________ Boy ________ Girl ________ Age ________ Present School Grade: _______________
Home Address & Contact Information:
 Street: ________________________________________________________ City & Zip: _____________________________________________ E-Mail Address: ________________________________________________________ Parent/Guardian: ______________________________________________________ Home Phone: __________________________________________ Work Phone: __________________________________________
In the Event of an Emergency, Whom Do We Call if We Cannot Reach You?
 Name: ________________________________________________________ Relation: _______________________________________________ Phone Number: ______________________________________________________
Medical or Other Information We Need to Know About Your Child: (include food allergies)
 
Who may pick up this child at the end of each day?
 Name: ______________________________________________________________ Relation: ____________________________________________ Phone Number: ____________________________________________________________ Name: ______________________________________________________________ Relation: ____________________________________________ Phone Number: ____________________________________________________________
*Written Notice Required if Your Child is to Leave with Persons Other Than Ones Designated Above*
 
 
HEALTHY RHYTHM COMMUNITY ART GALLERY
 ART CAMP FEE:
 $175 per ART CAMP (Includes ALL art supplies, instructor fees and light snacks)
HOURS:
 12 Noon to 5 PM, Monday-Friday
 ART CAMP 1
 (June 23-27) _______
 ART CAMP 2
 (July 21-25) _______
BOTH CAMPS
 _______
PAYMENT METHOD
 (Please Circle One): I. CASH II. CHECK (made payable to "KEN VAIL") III. CREDIT CARD (3% Fee)
PAID:
 $_________________.00 1. I hereby give permission for my child to participate in this program. 2. Appropriate behavior and respect for staff, instructors, property, and other young people must be demonstrated by Campers at all times. Failure to behave appropriately may result in dismissal from ART CAMP. 3. Your signature also gives HEALTHY RHYTHM COMMUNITY ART GALLERY approval to use photos of your children in promotional brochures, news articles, or other literature published by/for the ART CAMP. Check here if you
DO NOT
 
want your child’s photo used for promotional purposes related to the Gallery and/or ART
CAMP _______ My signature below indicates I have read and understand the information contained herein and agree to comply with al information. In consideration of the opportunity afforded to the undersigned to participate in any ART CAMP activity, the undersigned hereby knowingly, freely, and voluntarily waives any right or cause of action against HEALTHY RHYTHM COMMUNITY ART GALLERY, its owners, instructors, and volunteers arising out of any claim whatsoever as a result of any injuries to body, life, limb, or property arising from participation in the hereinafter described activity. The undersigned shall hold harmless HEALTHY RHYTHM COMMUNITY ART GALLERY from and against all
judgments, orders decrees, attorney’s fees, costs, expenses, and liabilities arising from or out 
 of such claim, investigation, or defense thereof that may be entered, incurred, or assessed as a result of the foregoing. Parent/Guardian Signature: _____________________________________________________ Parent/Guardian of: ______________________________________________________ Date: ________________________________

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