2019 Registration

WELCOME TO SUMMER ARTS CAMP 2019!

Registration is a two step process:

STEP 1: Registration Form ~ Please ensure that you press “SUBMIT REGISTRATION” at the end of the form before proceeding to payment.

STEP 2: Payment ~ Add to Cart buttons selected will take you directly to PayPal.  If you do not have a PayPal account, please choose the “Check Out – Pay without a PayPal account” button on the shopping cart page.

CONFIRMATION: Once the registration form and payment have been submitted, you will receive a confirmation email from Glenhyrst.  This is not an automatic email, and will be sent as soon as possible following your registration.

If you have any questions or require assistance, please call the Gallery at 519-756-5932.

 

Please read our CAMP SAFETY POLICY before proceeding to registration. You will need to check off that have done so before submitting the registration form.

 

STEP 1: REGISTRATION FORM

CHILD AND FAMILY INFORMATION

CHILD'S FIRST NAME:
*REQUIRED FIELD

CHILD'S LAST NAME:
*REQUIRED FIELD

BIRTHDATE YYYY-MM-DD:
*REQUIRED FIELD

CHILD'S ADDRESS:

*REQUIRED FIELD
CITY:

*REQUIRED FIELD
POSTAL CODE:

HOME PHONE NUMBER:
*REQUIRED FIELD

RESIDES WITH:
*REQUIRED FIELD


PRIMARY CONTACT:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:
*REQUIRED FIELD

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD

EMAIL (USED TO SEND OUT CAMP INFORMATION):
*REQUIRED FIELD

SECONDARY CONTACT:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD


EMERGENCY CONTACTS (IF PRIMARY OR OR SECONDARY CONTACTS CANNOT BE REACHED). AN ADULT 16 YEARS OR OLDER WHO CAN ASSUME RESPONSIBILITY FOR THE CHILD).
NAME:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:
*REQUIRED FIELD

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD


AUTHORIZED PICKUP:
NAME OF PERSON(S) WHO CAN PICK UP CHILD (IF APPLICABLE) OTHER THAN PRIMARY OR SECONDARY CONTACTS OR EMERGENCY CONTACTS:
*REQUIRED FIELD

DO YOU GIVE US PERMISSION TO TAKE PHOTOS OF YOUR CHILD FOR PROMOTIONAL PURPOSES? NAMES WILL NOT BE USED.YESNO


INDIVIDUAL CAMPER INFORMATION

Indicate if came experiences or has experienced any of the following:

ALLERGIES:YESNO
IF YES, INDICATE TYPE:

MEDICAL: (ie: Vision/hearing/seizures/Diabetes/Mobility:

ASTHMA:YESNO
INHALER:YESNO

CURRENTLY TAKING MEDICATION?YESNO
IF YES INDICATE TYPE:

DEVELOPMENTAL/LEARNING: (ie: ADD/ADHD/Autism/Delays):YESNO
IF YES INDICATE DETAILS:

DOES YOUR CHILD REQUIRE ADDITIONAL ASSISTANCE? YESNO
If yes indicate if there is anything we should know concerning school, relationships, learning abilities, etc?

DOES YOUR CHILD REQUIRE AN EA AT SCHOOL? YESNO
IF YES, PLEASE INDICATE IF AN EA HAS BEEN ARRANGED FOR CAMP (Camp policy states that if an EA is required at school then an EA must also accompany your child during camp).

IS YOUR CHILD IMMUNIZED?YESNO

TO GROUP YOUR CHILD WITH SAME AGED PEER, PLEASE INDICATE THEIR NAME AND WEEK THEY ARE ATTENDING. WE DO OUR BEST BUT THIS IS NOT GUARANTEED. DUE TO CLASS SIZES AND RATIOS, CHANGES CANNOT BE MADE THE DAY OF ARRIVAL.

PLEASE CHECK TO INDICATE YOU HAVE READ AND UNDERSTAND THE CAMP POLICIES AND SAFETY GUIDE.

Yes I have read the Camp Safety Policy.

CLICK ON THE BUTTON BELOW TO SUBMIT YOUR FORM. PLEASE NOTE THAT PAYMENT IS A SEPARATE STEP THAT IS PROCESSED THROUGH PAYPAL. REGISTRATION CANNOT BE COMPLETED WITHOUT BOTH THE COMPLETED REGISTRATION FORM AND PAYMENT.

 

Please ensure that you have pressed the “SUBMIT REGISTRATION” button BEFORE selecting your payment buttons.

 

STEP 2: PAYMENT

Not yet a member? Purchase a Youth membership for $20, or Family membership for $40, and receive the member pricing on each camp week!


Membership Types




WEEK 1: July 2 – 5
WHERE THINGS ARE WILD!


Registration Fees
Child’s name:




WEEK 2: JULY 8 – 12
FULL STEAM AHEAD!


Registration Fees
Child’s Name:




WEEK 3: July 15 – 19
GLENHYRST’S GOT TALENT


Registration Fees
Child’s Name:




WEEK 4: July 22 – 26
DIY IT!


Registration Fees
Child’s Name:




WEEK 5: July 29 – August 2
FROZEN IN TIME


Registration Fees
Child’s Name:




WEEK 6: August 6 – 9
SECRET SPY SCHOOL


Registration Fees
Child’s Name:




WEEK 7: August 12 – 16
GLENHYRST ART OLYMPICS


Registration Fees
Child’s Name:




WEEK 8: August 19 – 23
MYTHICAL CREATURES


Registration Fees
Child’s Name:




WEEK 9: August 26 – 30
ART AVENGERS


Registration Fees
Child’s Name: