Facets Academy - Summer Camp Application
Participant Age (as of August 31):
Cell Phone #1 (Parent/Guardian):
Cell Phone #2 (Parent/Guardian):
Other Phone (Home/Work):
Emergency Contact other than yourself (name, relationship & phone):
How did you hear about Facets Kids Film Camp?
Facets Kids Film Camp:
LAKE FOREST SESSION June 12 - 16, 9a-5p (Ages 8-14) - $500
June 19 - 23, 9a-5p (Ages 7-10) - $450/$405
June 26 - 30, 9a-5p (Ages 11-14) - $450/$405
July 10 - 14, 9a-5p (Ages 11-14) - $450/$405
July 17 - 21, 9a-5p (Ages 7-10) - $450/$405
July 24 - 28, 9a-5p (Ages 11-14) - $450/$405
LISLE SESSION July 24 - 28, 9a-5p (Ages 8-14) - $500
July 31 - August 4, 9a-5p (Ages 7-10) - $450/$405
Hitchcock Film Camp
June 26 - 30, 9a-2p (Ages 10+) - $450/$405
Acting for Film
July 10 - 14, 9a-2p (Ages 8-14) at Greenhouse Theater Center (2257 N. Lincoln Avenue, Chicago) - $450/$405
Pro-Path Film Camp:
July 31 - August 11 (Ages 10-15) M-F (9a-2p) - $700/$630
Animation Film Camp
August 14 - 18, 9a-2p (Ages 10+) - $450/$405
Horror Film Camp
Saturdays, September 16, 23, 30 & October 7 & 14, 10a-3p (Ages 8-14) - $450/$405
$700 (Pro-Path Film Camp)
$630 (Pro-Path Film Camp - Member Discount)
$500 (Facets Kids Film Camp - Lake Forest & Lisle Sessions)
$405 (Member Discount)
$250 (Feminist Film Camp)
$225 (Feminist Film Camp - Member Discount)
N/A (not applicable)
Paying by credit card, check or cash.
Credit Card Number & Expiration Date (to be charged):
Cardholder Name (Authorizing the Charge):
SIGN IN/OUT PERMISSION:
YES - My child can sign themselves in and out of the program. Facets staff are not responsible for young people who have signed out.
NO - My child cannot sign themselves in or out of the program. A parent or guardian will sign them in and out each day.
The following individuals have permission to sign my child in and out (Name & Relationship to Child):
NO - My child has no health concerns.
YES - My child has health concerns (please detail below).
Please detail health concerns (allergies, physical or mental challenges, chronic illnesses):
Please detail action to be taken in regard to health concerns listed above:
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