9th Annual D2GB Children's Performing Arts Camp - Individual Application Form
Date: Monday August 1-Friday August 5, 2016
Time: 9:30am to 3:30pm daily

Note: Parents are responsible for transportation to and from our location.
Application Deadline: Friday June 17, 2016

Camper's Name/Nombre del participante *
Your answer
Camper's Age/Edad del Participante *
Your answer
Camper's Address/Dirección del Participante *
Your answer
Parent/Guardian Name: Nombre del Padre/Guardian *
Your answer
Parent/Guardian Email: Email del Padre/Guardian *
Your answer
Parent/Guardian Phone: Numero de Telfono del Padre/Guardian *
Your answer
In case of an emergency, please provide the name and phone number of the person we should contact: En caso de emergencia, escribe el nombre y numero de telefono. *
Your answer
Have you been a part of our D2GB Camp before?/ Has participado en nuestro campamento? *
Please describe how the applicant is currently "going beyond" and how the applicant can benefit from this program: Por favor describe como el aplicante actualmente se ATREVE A MAS y como podria beneficiarse de este programa. *
Your answer
Do you want to register for R.Evolución Latina's Dance-a-thon, an event that fundraises for programs like this? *
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