Libertyville Teen Film Camp
Teen Camps 7th-12th

Weekdays 9:00-3:00pm

6/26-7/7
7/10-7/21
7/24-8/4

$625 Two Week Tween Camps
$150 Deposit due back with registration

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 *
Your answer
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