Mural Mania!  V                                                              July 5- August 5, 2022                                         Summer Arts Enrichment Camp Registration
A 5-WEEK SUMMER MURAL ARTS PROGRAM FOR BUFFALO PUBLIC SCHOOLS STUDENTS ENTERING GRADES 6-12 STARTING SEPTEMBER 2022.

PROGRAM SITE: Bennett Park Montessori #32, 342 Clinton Street, Buffalo, NY 14202

There is space for 30 student artists. All students must commit to 5 weeks of the program. Students will be chosen by lottery if registration exceeds slots available. .

Breakfast and lunch will be available to all participating students. NFTA bus passes will be available for students to use during the summer program.

Confirmation of your registration will be emailed to primary contact listed no later than June 20, 2022.

This is an online registration form. You will receive a confirmation email once it is submitted.

IF YOU NEED TO PRINT THIS FORM, PLEASE DIRECT YOUR REGISTRATION APPLICATION TO:
Michele Agosto, Director of Arts or Audrey King, Arts Administrative Assistant
EMAIL:  magosto@buffaloschools.org   OR    aking@buffaloschools.org

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Email *
First Name of Student *
Last Name of Student *
School *
Grade *
Age *
Student Artist's Gender Identity
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Student Cell Phone *
#1 Parent Name/Guardian (PRIMARY CONTACT) *
Home Phone Number #1 Parent/Guardian (PRIMARY CONTACT) *
Cell Phone Number #1 Parent/Guardian (PRIMARY CONTACT) *
 #2 Parent/Guardian Name (SECONDARY CONTACT) *
Home Phone Number #2 Parent/Guardian (SECONDARY CONTACT) *
Cell Phone Number #2 Parent/Guardian (SECONDARY CONTACT) *
Student Artist's Home Address *
Primary Email Address (confirmation will be sent to this email address) *
Any Allergies or Medical Conditions? Please list all. *
Do you agree to allow your child to be photographed and videotaped as part of the marketing of this program? *
Any additional comments
A copy of your responses will be emailed to the address you provided.
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