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Escuelita Art- es Summer Registration Form
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Email
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Your email
Summer Camp Schedule 2024
Session Or Week I'm Registering For:
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Your answer
Student Name
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Your answer
Student Age & Birthday
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Your answer
Parent Name
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Your answer
Address
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Your answer
Phone Number
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Your answer
Child Medical/Photo Release For Summer Camps
Childs Medical Doctor Name, Address & Phone
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Your answer
Hospital of Choice in Case of Emergency
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Your answer
I consent to my child being videotaped or photographed for education, performance or advertising purposes.
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Yes
No
I have read the foregoing and agree with it in all respects. (Signature & Date)
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Your answer
Payment is due upon submission of registration form. Venmo QR is available below. For other payment options please contact Odette Solitaire Phone: (512) 965 -3604 Email:
osolitaire@gmail.com
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