You are on page 1of 2

RegisterForCamp

RegisterForCamp
PleasereturnthisformbyJune14,2010.
Alate-enrollmentfeeof$20willbeassessedforregistrationafterJune14th.

Name____________________________________________ _______
_______________

_________ Male/FemaleGradeinFall2010___
Age_______
_________ ______
_______
_______
__

Camper’sT-ShirtSize:Youth________
__________
________Adult_
____ ________
________

School_____________
____________________
_______________________________
_____________________________________
______________________________
___________________

Parent’sName_______
_______________
________________________
___________________________________
___________________________
__________________

Phone__________
___________
__________
_______
_____E-mail_______________
__ ____________________
____________________________
_____________
________

Address____________
_________________
__________________________
_____________________________________
________________________________
_______________________




Howdidyouhearaboutthiscamp? ____________
________________
_________________
___________________
_______________
________

IgivepermissionformychildtoparticipateinCasciaHall’sPerforming
July19th–30th,2010
ArtsCamp,andIunderstandthatCasciaHallandthecampstaffarenot Monday–Friday9:00amto3:15pm
liableforanyinjurythatmayresultfromcampactivities. 
 PerformanceFriday,July30that1:00pm
Signature____________
_______________________
_________________________________
__________________________
_______________
_____ 

 Opentostudentswhoareentering
Date_________________
_________________
_________________ Grades3rd–8th
 


 Studentsfromallschoolsarewelcome!
Pleasemakecheckpayableto
RebekahPeddy 
Mailto:
CasciaHallPerformingArtsCamp
2520SouthYorktownAvenue
Tulsa,OK74114

Questions?Formoreinformationcontact
RebekahPeddy
Asst.Director,CasciaHallPerformingArtsCenter
918-746-2680
rpeddy@casciahall.org

You might also like