The Painted Pot
Summer Camp Registration Form
Parent Name(s):
Phone
Address1
Address2
City
State
Zip
Email Address
Child Name #1
Child Name #2
Child Name #3
Child Name #4
Known Allergies
List of all Medications
Emergency Contacts ( must also be authorized to pick up child):
Name 1
Phone 1
Name 2
Phone 2
We have weekly morning summer camps starting the first week of June ending with the second week in August. We will not have a camp the week of July 4th. New this year we have added two Saturday camps. We also have two separate times (morning & afternoon) available on Saturdays. Please check the website for time availability.
MORNING CAMPS:
CHOOSE CAMP NAME HERE
Shakin’ It Up
Ceramic Crazy
Kids N’ Clay
Decorate My Room
Petite Picassos
AFTERNOON CAMPS:
CHOOSE CAMP NAME HERE
Princess in Training Camp
Shakin’ It Up
Kids N’ Clay
Additional Camps
CHOOSE CAMP NAME HERE
Handbuilding 101
Kids n Clay
Glass Fusing
Picture Frame
Slumped Dish
Glass Jewelry
Session Attending Date(s)
Comments
Please Read The Following Before Signing:
A $55 non-refundable deposit is required to reserve a slot in each camp session.
Cancellation Policy: If the unfortunate situation occurs that we must cancel any session that you have signed up for due to lack of enrollment, a full refund will be issued. Any customer that has pre-paid, that cancels a session with less than a week notice will not receive a refund.
By typing or signing your name
here you are agreeing to all the terms stated above and realize this is a legal and binding contract.
Signature
(or typed for web reservations)
Date
Please
print out this page
for your records, THEN click the submit button below.
