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Rhizome DC 2023 Summer Camps
Details for all camps here:
http://www.rhizomedc.org/youth-programs-1/
Please fill out a separate form for each child. Thanks!
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For reduced price / sliding scale please email
info@rhizomedc.org
. 20% sibling discount.
July 24-28 * 9am-3pm * Activist Art * $360 * Ages 10-13
July 31 - August 4 * 10am-4pm * Field Trip Camp * $360 * Ages 10-13
August 7-11 * 9am-3pm * Graphic Novel Camp * $360 * Ages 10-14 [FULL - IF YOU SIGN UP YOU WILL BE PLACED ON A WAITLIST]
August 21-25 * 9am-4pm * SculptureStories * $420 * Ages 8-12 [FULL - IF YOU SIGN UP YOU WILL BE PLACED ON A WAITLIST]
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Participant's Name
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Your answer
Birth date
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*Please change the year to the correct birth year.*
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DD
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YYYY
Parent or Guardian Name
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Your answer
Address
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Your answer
Parent phone
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Your answer
Emergency Contact in case parent/guardian can't be reached
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Your answer
Emergency Contact address
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Your answer
Emergency Contact phone number
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Your answer
Allergies?
Your answer
Is there anything that would be helpful for our facilitators to know in working with your child?
Your answer
Photo Release
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It is useful for publicizing future events to use photos taken during camp. That said, we respect the wishes of anyone to not have their child's image used for these purposes. Please check one option below:
I grant the instructors and Rhizome DC permission to use photographs of my chilld (without naming the child) for any lawful purpose including publicity.
I do not grant the instructors or Rhizome DC permission to use photographs of my child for any purpose.
Liability Release
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Every reasonable precaution will be provided for the safety of the children while participating in camp activities.
I acknowledge that neither the instructor, nor Rhizome DC are liable in the event of accident or injury to my child.
How would you like to pay?
*
Venmo to @rhizome_dc (no service fee)
Zelle to RhizomeDC, Inc //
info@rhizomedc.org
(no service fee)
Paypal to
info@rhizomedc.org
(please add 3% to cover fees)
Check to Rhizome DC / 6950 Maple St NW / Washington DC / 20012
I am emailing
info@rhizomedc.org
to discuss scholarship options and/or an installment plan.
e-signature: Please initial to e-sign.
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A copy of your responses will be emailed to the address you provided.
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