2020 - Storytime Explorers Registration Form

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Thank you for interest in this Creative Arts Camp for ages 5-8. Program meets 9:30am - noon, August 24 - 28, 2020. Students must attend all days including the final day for the performance. Families are invited to watch the performance at 11am on Friday August 28.

Email *

Participant Last Name *

Participant First Name *

Participant Address *

Participant City *

Participant Zip Code *

Parent Guardian Name (First, Last) *

Parent/ Guardian Address

If different from student

Parent/ Guardian E-Mail *

Cell / Primary Phone Number *

xxx-xxx-xxx

Emergency Contact Name (First, Last) *

Emergency Contact Primary Phone Number *

xxx-xxx-xxx

Student's Academic School & Grade (if applicable) *

Student Age *

How old will the participant be this August?

Allergy / Medical Conditions *

Please list any physical / emotional challenges, chronic illness/conditions, allergies, or language barriers that may affect your child's participation & understanding in class (Example: Asthma, Diabetes, Dyslexia, ADHD, Auditory Processing Disorders, etc). Or write "none"

Emergency Medical Conditions / Treatment *

Example: "Epi Pen for Bee Stings". Describe if applicable, or write "none"

How did you hear about this program? *

Past participant, friend recommendation, newspaper, our website, online camp listing, flyer etc.

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