Registration - Community Play Atelier Summer Camp 2024

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Event Timing: Summer 2024
Event Address: 153 North Timber Lane Cheshire, CT 06410
Contact us at (267) 210-9138 or communityplayatelier@gmail.com

Email *

Parent(s)/Guardian(s) names, phone-numbers: *

What is your child's birthdate? *

YYYY

Your child's (preferred) name: *

Has you child attended a drop-off school program or camp before? *

Which week(s) of camp will your child attend?

*All camp programming from 9:30am - 11:30am each day

Week 1 - June 17th to 20th Animal Enthusiasts $150

Week 3 - July 8th to 11th Under-sea Explorers $150

Week 4 - August 5th to 8th Enchanted Artists $150

Week 6 - August 19th to 22nd I Love Myself! Camp $150

Required

Does your child have allergies? Please list below: *

I acknowledge that my child uses the toilet independently. *

Yes, my child uses the toilet independently.

No, my child does not use the toilet independently.

Other:

Required

What are your child's interests? *

What would you like us to know about your child? What are some ways that we can best support your child in feeling safe and comfortable at camp?
*

Emergency Contact information (Please include daytime phone-number and relationship to child): *

List of adults with permission to pick up my child from camp (please include phone number): *

Please list your child's pediatrician: *

As a parent or guardian of my child, I agree that I will not hold Community Play Atelier liable for any personal injury, property damage or loss of insurance. I agree to release and hold harmless Community Play Atelier and owner, Jeannine Sloane, from all liability incurred as a result of my child’s participation in studio class and that these terms serve as a release for me, volunteers, property owners and members of my family. *

Yes

Other:

I acknowledge and give permission for photos to be taken of my child and their work to be shared with camp families, on the Community Play Atelier website, and on social media for studio promotion. *

Yes

Other:

Required

I understand that my child's full camp payment is due at the time that I am completing this registration form, using the Venmo application (account: @communityplayatelier), or my child's spot in camp may not be saved. Payments for camp are non-refundable after May 1st. Please email communityplayatelier@gmail.com to discuss potential payment plans if need be. We would like for this to be an opportunity accessible to all interested families regardless of socioeconomic status.

*A link for Venmo payment can also be found on the website. https://communityplayatelier.com/

Yes, I will pay my child's camp rate through the Venmo application either during or directly after completing my registration forms.

Other:

Required

A copy of your responses will be emailed to the address you provided.

Submit

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