LHF Lao Art and Culture Summer Camp 2022 Registration
Dear Parents,
Your children are invited to participate in the Lao Heritage Foundation’s 2022 Art and Culture Summer Camp in the D.C. metro area.  This is an exciting opportunity for children to learn about their culture and share the experience with kids from other states. At the end of camp, there will be a meet and greet and final performance for families and friends on Saturday, July 30. More information on the performance will follow.

Lunch and snacks will be provided to all campers for the duration of the camp by LHF.  Parents are welcomed to attend, observe and/or help run the camp.  Please complete the attached forms.  If you have any questions, please contact Niphasone Souphom at 202-607-7466 or thooktik@yahoo.com.

When: Saturday, July 30 to Saturday, Aug. 6.
  Time: 9:00AM-4:00PM  
Where: 4113 Westman Ct. Alexandria, VA, 22306.
Who: Children 6 years and older
Cost: $125/person (to cover food and supplies for one week)

Activities: Music (kaen, saw, kim, lanad, kong wong, flute, drum, xing), Dance, Culture (art, cooking, sports, theater, literature, language, and etiquette)

How: Fill out the attached forms and return by Friday, July 4th.  Money is due with application.  

Payment: $125/person  Check made out to:
Lao Heritage Foundation
4113 Westman Court
Alexandria, VA 22306

Paypal: https://www.paypal.com/paypalme/laoheritageLHF
Venmo: @laoheritage
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Child’s name (please provide the name that your child prefers as well such as a nick name, family name, etc.) *
Age *
Gender *
Does your child have any experience with music?  If yes, please describe (what instruments, if they can  read music notes) *
Does your child have a music instrument in mind that they want to learn?  (lanad ake, lanad toom, kim, kong wong, saw, khaen, kui, drums).   *
Does your child have any experience with dancing? (If yes, please describe, what type and for how long) *
T-shirt size *
Parents/Guardians Full Name *
Home Address: Please include city, state, and zip code *
Parent Phone number *
Parent Email *
1. Emergency Contact Person, phone number, and relationship to child *
2nd Emergency Contact Person, phone, number, and relationship to child
What medication is the child taking that we need to be aware of? *
Does you child have any allergies?  (food, etc-please list them) *
Primary Care Physician’s Name or clinic name and phone number *
Person authorized to pick up your child *
Please list any physical limitation or any other information that you would like to share about your child. *
I would like to donate
I would like to volunteer
If you are volunteering, please provide us with your T-shirt size
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If you are volunteering, please provide your name and phone number.
RELEASE FORMS    PERMISSION STATEMENT                    I give permission for my child to participate in the Lao Art and Culture Summer Day Camp hosted by the Lao Heritage Foundation (LHF). I give my permission for the above named student to be treated by a medical professional as deemed necessary by LHF and its staff, and for them to secure my child’s medical, dental, surgical, x-rays, and anesthesia help as deemed necessary. I also give permission for LHF and their representatives to provide supervision for my child during programs conducted at 4113 Westman Ct., Alexandria, VA, 22306. I understand that such participation is voluntary.  All conditions of the program have been explained to my satisfaction. CONSENT AND RELEASE I agree to release LHF and their representatives from all liability, loss, damage, costs, claims, or causes of action including, but not limited to, bodily injuries and property damage arising from participation in LHF events, or any activities sponsored or organized by LHF.I further agree to indemnify and hold harmless LHF and their staff, organizers and agents from any and all liability, loss, damage, costs, claims, or causes of action, including attorney’s fees and witness costs, arising out of the undersigned’s participation in this community summer camp. MEDIA RELEASE I hereby authorize LHF to use my child’s picture for its public relations activities, which may include its newsletter, brochure, photo displays, and/or other organization and program promotional materials which may be include LHF website and facebook.                                                                            I understand that I have the right to revoke this consent in writing, at any time, except to the extent that action has been taken in reliance upon this consent.  I further understand that I have the right to request a restriction as to how the picture is used.    Please print name below. *
LHF Camp Rules and Regulations  1. Have fun  2. No bullying  3. No foul language  4. No weapons  5. No drugs  6. No fighting  7. An adult must know where you are at all times  8. Stay on camp premises at all times  9. Respect others and their properties  10. Pick up after yourself    Consequences:  1. If infractions are minor, you will receive a warning and be removed from the session and rejoin at the next session.  2. If infractions are severe, parents will be notified and you will be removed from camp activities for the day  3. If it is a second time, you will be removed from camp for the rest of the week.                                                                        I have read and understand the camp rules.  I understand that I may be removed from camp for breaking camp rules. Please print name below. *
LHF Covid 19 Procedures  All students attending LHF summer camp must provide proof of vaccination.   Students are required to wear masks on the camp site except while eating or are outdoors and are 6 feet apart.   Students who test positive, will not be able to return to the campsite as camp is only 7 days.  All adults, teachers, parents, and volunteers must also wear masks on site except while eating or are outdoors and are 6 feet apart.  Acknowledgement: I have read the LHF Covid-19 procedures and understand that I must provide proof of vaccination for my child and that my child and I will have to wear a mask on the campsite except for when we are eating or are outside.  Please type name below. *
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