BECKY JOY, AMANDA JOY &

MRS. ORCUTT’S - 2015 JOYFUL

SUMMER ART CAMP

 

  STUDENT NAME:  ______________________________________

 

  STUDENT’S GRADE (2014-15 SCHOOL YEAR): ______        

DATES REQUESTED: PLEASE LIST YOUR 1ST CHOICE (#1) AND 2ND CHOICE (#2) IN CASE CLASSES FILL

 

             JULY 7-10        (TUESDAY-FRIDAY):      8:45 AM TO 1:00 PM): _________      

              JULY 13-16    (MONDAY-THURSDAY):    8:45 AM TO 1:00 PM): _________

             JULY 20-23    (MONDAY-THURSDAY):    8:45 AM TO 1:00 PM): _________

  FOOD ALLERGIES (FOR SNACKS THAT WE PROVIDE): _______________________

 

 

CONTACT INFORMATION:

PARENT / GUARDIAN: _________________________________________

PHONES - CELL: ___________________  HOME: __________________

WORK: _______________ EMAIL: ___________________________

 

I HEREBY CERTIFY THAT I AN THE LEGAL GUARDIAN OF _________________, AND THAT I  GIVE PERMISSION FOR HIM / HER TO ATTEND THE ORCUTT GIRLS’: 2015 JOYFUL ART CAMPS:

 

SIGNED: _________________________________ DATE: ____________

 

PLEASE MAIL REGISTRATION FORM AND $175 CHECK MADE OUT TO:

JOY ORCUTT TO GUARANTEE YOUR SPOT IN THE CAMP.  MAILING ADDRESS:

 

JOYFUL ART CAMP

46220 SE 139TH PLACE        NORTH BEND, WA      98045

EMAIL ANY QUESTIONS TO US @ JOY.ORCUTT@CENTURYTEL.NET