MOSAIC Arts Camp 2022 - WAITING LIST
REGISTRATION IS CLOSED FOR CAMP - YOUR CHILD WILL BE PLACED ON A WAITING LIST, WE WILL CONTACT YOU IF A SPOT OPENS UP! PLEASE DO NOT PAY UNTIL WE CONTACT YOU -  THANKS

CAMP is June 13-17, 2022.  Camp is held daily, Monday - Friday from 8am-12pm.  Friday evening, we will have a time for campers to showcase their artwork in our MOSAIC Museum. (More info to come)
 Each camper will pay a $35 supply fee.  This fee will help to offset the cost of art materials and supplies. There are scholarship applications available. If you have questions regarding camp or scholarships please contact Leigh Thomas by email at fbcmosaicartcamp@gmail.com  If you have an urgent question during business hours, contact the church office at 706-778-4412.
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Email *
Student's First Name *
Student's Last Name *
Student's DOB (Children must have completed Kindergarten to participate) *
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DD
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YYYY
Mailing Address (Street) *
Mailing Address (City) *
Mailing Address (Zip Code) *
Parent Name *
Only list one parent's name here, the other parent can be listed as Emergency Contact below.
Parent Cell Phone Number *
Only list one parent's number here, the other parent can be listed as Emergency Contact below.
Parent Home Phone Number
Parent's Email Address *
Church Affiliation
Names of siblings attending MOSAIC camp? (These are the names that will appear on your car pick-up tag).
Emergency Contact #1 Name *
Emergency Contact #1 Number *
Emergency Contact #2 Name *
Emergency Contact #2 Number *
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