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Libertyville Teen Film Camp
9:00a-3:00p each session

SESSION ONE: 6/11 - 6/22
SESSION TWO: 6/25 - 7/6
SESSION THREE: 7/9 - 7/20
SESSION FOUR: 7/23 - 8/3

$625 Two Week Camps

Student Name *
Your answer
Which Weeks? *
Required
Grade (Fall) *
Your answer
Parent/Guardian Contact 1 *
Your answer
Phone number (cell) *
Your answer
Phone number (home)
Your answer
Phone number (work)
Your answer
Parent/Guardian (Contact 2) *
Your answer
Phone number (cell) *
Your answer
Phone number (home)
Your answer
Phone number (work)
Your answer
Student's Doctor's Name and Number *
Your answer
Medical Conditions Staff should be aware of (allergies, behavioral, etc) *
Your answer
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