Santa Cecilia Arts & Learning Center: 2017 Summer Arts Camp Registration Form
Thank you for your interest in our Summer Arts Camp! This is our online registration form. Please note that this is not the payment section, which you must return to (if you have not already completed it) after finishing this form.
How did you hear about us?
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First Time Camper or Returning
Student Information
First Name
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Last Name
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Nickname / Preferred Name (if applicable)
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Age (our camp is for age 6 - 12)
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Gender
Grade
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School
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Parent Information
First Name
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Last Name
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Email Address (required for camp forms)
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Address
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Address 2nd Line (apt #, etc.)
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City
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State
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Zip Code
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Main Phone
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Secondary Phone (if applicable)
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Emergency Contact
Same as Parent Information (if so, no need to fill in this section)
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First Name
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Last Name
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Phone Number
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Relation to Child
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Secondary Contact / Secondary Emergency Contact
First Name
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Last Name
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Phone Number
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Relation to Child
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Child's Doctor, Health, & Insurance Information
Name of Doctor
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Doctor's Phone Number
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Does your child have any allergies? If so, please specify them here
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Insurance Provider
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Insurance Phone Number
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Insurance Account Number
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Session Selection
Camp Hours: Weekdays from 9:00am - 5:00pm, 30 minute grace period for pick-ups and drop-offs

Activities: musical instruments, singing, dancing, drawing

$265 per student per session, $210 for siblings, $225 early bird special before April 1st ($200 early bird sibling rate)

Each session is unique. The more you attend, the more you learn!

Please sign my child up for:
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Camp Location
Santa Cecilia Arts & Learning Center
2751 West Broadway, Eagle Rock (Los Angeles) 90041

Find us on Google Maps

Across the street from the Eagle Rock Plaza Mall

Ample parking available for drop-off and pick-up

See our website or Facebook page for pictures of our beautiful center!

DON'T FORGET!
After submitting this registration form, please return to the Summer Camp page to pay for each session in which you have enrolled your child. The link may be accessed here: http://scorchestra.org/summer-arts-camp/

After you have submitted the registration form and payment information, we will send another email with forms and waivers that must be signed before the camp begins.

Thank you again for your interest in our Summer Arts Camp! It's going to be a blast!

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