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 6-10 July 13-17 July 20-24 July 27-31 Aug 17-21 Aug 24-28 

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: Snacks and drinks are NOT provided. Each child needs to bring their own snacks, lunch and drinks / water bottle)

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 use pictures of my child on the Carolyn's Creative website or other promotional materials. (Please note: No names are ever posted with the pictures of people). (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. I understand that art camp hours are from 9am to 3:00pm. 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 one week prior to the beginning of each week selected. Payments may be made by e-transfer by mailing a cheque to Carolyn (See Camps for Summer 2020 for details). I accept.