Art Camp Registration form
24 King Oak terrace
Weymouth Ma 02189
617-780-7730
Registration Form
Child’s Name:__________________________________________
Child’s Age:_______
Mother’s / Father’s Name:_______________________ ______________________________
Address:________________________________________________________
Phone:______ ______ ______
Email_____________________________
Emergency Contact:________________________
Phone:______ ______ ______
Summer Art Camp 2019
Date course begins: ___ ___ ___Am session_____ PM session____Lunch____
Amount Due: ($225 plus $10 per day if staying for lunch) $ _________
Camp fee is nonrefundable
Please print this form and enclose payment , cash or checks made out to:
Art Barn
24 king oak terrace
Weymouth ma 02189
Any Food Allergies? Let me know
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Permission to photograph your child for advertising purposes? yes, no (circle)