Art & Games Camp FOR BEETHOVEN BEARS

Student Registration Form

Return this form and include payment to your child’s teacher no later than:
Monday June 15, 2009.
Make Checks Out To: Jennifer Swan, Get2It
Cost per week: 200.00
Questions? contact Jennifer Swan @ 310-383-7857, email: cree1326@mac.com

If more than one child from your household will attend, complete a separate form for each
child.
Students can attend more than one week as the activities will vary week to week.

My child will attend the following weeks (check off each week child will attend):
{ } Week 1: Monday June 22 – Friday June 26
{ } Week 2: Monday July 6 – Friday July 10
{ } Week 3: Monday July 13 – Friday July 17
{ } Week 4: Monday July 20 – Friday July 24
{ } Week 5: Monday July 27 – Friday July 30

As enrollment per week is limited to 15 participants and fills up quickly, indicate a first
and second choice for the weeks you would like your child to attend.
First choice: Week ( ) 1 ( ) 2 ( ) 3 ( ) 4 ( ) 5 – select one
Second choice: Week ( ) 1 ( ) 2 ( ) 3 ( ) 4 ( ) 5 – select one
PARTICIPANT INFORMATION
Student’s Name

________________________________________________________________________
last first middle initial

Grade: _______ Classroom Teacher’s Name:_________________________

PARENT GUARDIAN INFORMATION

MOTHER/GUARDIANS NAME: ___________________________________________

ADDRESS:

_____________________________________________________________________

PHONE #1: ___________________________ PHONE #2: ___________________ email: ____________

FATHER/GUARDIANS NAME: ____________________________________________

ADDRESS: _____________________________________________________________
PHONE #1: _____________________________ PHONE #2: ___________________ email: ____________
IN CASE OF EMERGENCY, AND PARENT/GUARDIAN CANNOT BE REACHED, CONTACT:

NAME:____________________________________ PHONE #:____________________

RELATION TO STUDENT: _________________________________________

OTHER THAN ABOVE GUARDIANS AND EMERGENCY CONTACT, WHO HAS PERMISSION TO
PICK UP CHILD?

NAME:_____________________________RELATION TO STUDENT:_____________

PHONE #:__________________________

Walking Field Trip/General Activity Permission Slip

To Farmer’s Market, Beach, Paddle & Basketball Courts

Walking field trips and art studio activities are an integral part of  the Art & Games
Camps, I/we request that my/our child, _______________________, be permitted to
participate in all art studio/games activities and attend all walking field trips. I/we
understand and agree that neither camp staff or volunteers shall be liable to
me/us or my/our child for any claims arising out of any such art studio activity,
field trip or game outing, such claims being hereby waived. I/we assume
responsibility for any acts of my/our child during any field trip and will indemnify
(reimburse or repay for any loss incurred) and hold the camp staff harmless from
any claims of any person arising  from my/our child’s acts.
_______________________________________________________ _____________________ 
Signature of parent or legal guardian Date 
_______________________________________________________ _____________________ 
Signature of parent or legal guardian Date 
CUT HERE AND SAVE THE ACTIVITY SCHEDULE AND CONTACT INFORMATION
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Activity Schedule   CAMP HOTLINE: 310­383­7857 JENNY SWAN’S EMAIL: cree1326@mac.com
th
8:15 am – 8:25 am Arrival @ 22 19  Place – curbside drop off  ­ look for the smiling valet!
8:30-10 am Art Every morning begins with free choice open art studio activities followed by
group instruction in a variety of visual art techniques. Friday’s culminating event will feature
student artwork. We will be painting and moving so wear comfy clothes that can get
dirty. Please wear sunscreen.
10:00-11 am Outdoor Physical Activities: Basketball, handball, beach games, sand sculptures,
mural painting.
Lunch 11:00-12 Please be sure to pack three healthy drinks, two protein-rich snacks, and a
BIG lunch for your camper! We will also be preparing healthy dishes to supplement lunches.
Afternoon “Summer Fun in the Afternoon” 
12:00- 12:30 Read Aloud: We will be reading from books like Sharon Creech’s ‘Love That Dog’ –
books that celebrate creative young people.
12:30-2 Creative Digital Documentation, Journaling, Open Studio. Photographs and stories will
be used to capture participant work and ideas. Students design their own web site page
depicting their work.
2:00-2:30 End of Day and Pick up
Things to bring everyday: water, bathing suit and shorts for water play or sand sculpture building, 
tennis shoes, a picture of a building you would like to draw (can be your home), any art projects you 
are working on, art supplies you want to use, towel, and a smile.