Perkins Summer Arts Camp Info & Permissions Form

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In an effort to safely and effectively ensure the highest quality instruction for all of our campers, please complete this form before your child's camp session begins. Enrollment in camp is subject to a thorough review and evaluation of the information provided. All applications are pending. There is a potential for assessment of tuition in the event that an initially enrolled student is later found ineligible.

CAMPER INFORMATION

Camper First Name, Middle Initial & Last Name *

Camper Date of Birth *

YYYY

List ALL camper allergies, as well as any medical conditions or limitations (Include any helpful details) *

Session (s) Attending at Perkins Moorestown *

Session M1: June 28 - July 9 (Skip 7/5)

Session M2: July 12 – July 23

Session M3: July 26 – August 6

Session M4: August 9 – August 20

Attending in Collingswood Location

Required

Session (s) Attending at Perkins Collingswood *

Session C1: June 28 - July 9 (Skip 7/5)

Session C2: July 12 – July 23

Session C3: July 26 – August 6

Session C4: August 9 – August 20

Attending in Moorestown Location

Required

Age at Time of Camp

Camper's School and Location *

Grade Completed *

Parent(s)/Guardian(s) First and Last Name *

Mailing Address (street, city, state & zip code) *

Primary Phone *

Secondary Phone *

Email address *

Emergency Contact's Full Name, Relationship, and Phone *

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