Your Name (required)

Your Email (required)

Your Child's Name

Your Child's Age

Your Daytime Phone Number

Alternate Daytime Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Child

I am registering my child in the following week(s):
July 8-12 July 15-19 July 22-26 July 29-Aug 2 Aug 26-30 

Who will drop off/pick up my child each day?

Please list any food or other allergies or health conditions I should be aware of, or medication your child will be taking while with me (Note: Healthy snack and drinks provided but each child needs to bring their own lunch)

Are there any other special needs I should be aware of to help me care for your child while at art camp?

I give my permission to Carolyn Schaub to take my child to Sydenham beach, on nature walks, and to the sports field for active games during art camp days

I give my permission to Carolyn Schaub to allow my child to swim at Sydenham beach during art camp days (yes/no)

I give my permission to Carolyn Schaub to use pictures of my child on the Carolyn's Creative website or other promotional materials (yes/no)

I heard about the art camps from:
Poster Carolyn's Creative Website On-line advertising A family member A friend Other (please complete textbox) 

My child was invited to join the art camp their friend (name of friend):

I verify that the medical information submitted above is accurate and complete. By clicking the box below I am registering my child for the week(s) of art camp specified above and directing Carolyn to follow my wishes about my child participating in swimming at Sydenham beach. I understand that art camp hours are from 9am to 4:30pm and that early drop off or late pick up must be pre-arranged with Carolyn for an additional fee. A payment of $50 per week must be submitted to Carolyn in order to hold my child's space in the week(s) specified. The remainder must be paid in full prior to the beginning of each week selected. I accept.