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Summer 2023
Academy Breakout
Registration Form
Please submit by Friday, June 16th
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Email
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Student Name:
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Student cell phone number
Your answer
Parent/Guardian Name:
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Your answer
Parent/Guardian email address:
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Your answer
Parent/Guardian phone number
Your answer
Check each activity or workshop you would like to sign up for:
Digital Media Smorgasbord
SAT Prep
College Essay Writing
Art and the Outdoors: Shibori
Art and the Outdoors: Painting Nature
Art and the Outdoors: Jewelry Making
Art and the Outdoors: Macrame and Plants
Art and the Outdoors: Pesto Pasta
A copy of your responses will be emailed to the address you provided.
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