Port Chester Council for the Arts 2019 ARTSCAMP Registration Form
Please complete this online form FOR EACH CHILD you wish to register for camp in its entirety.

This form is only to eliminate the need for you to mail back all of the forms by the JUNE 11th deadline.

To secure your child's spot, send a NON-REFUNDABLE $100 check or money order to:
Port Chester Council for the Arts
P.O. BOX 15
Port Chester, NY 10573

If you would like to make your deposit or camp payment via PayPal, the link is posted on our website (www.portchestercfa.org). A $25 per child processing fee will be added.

A hard copy of all registration/signature forms are required and need to be signed and submitted by the first day of camp!

Here is a list of programs and pricing for the entire 5 week program:

MORNING ARTSCAMP ONLY- GRADES K-10 (8:45am-11:45am):
$600 – MORNING ARTSCAMP ONLY
**This is the ONLY option for students entering kindergarten in September of 2019**

FULL DAY PROGRAMS (8:45am-4pm):
1st-4th Grade in September 2019 - ARTSCAMP & SHOW - SCHOOLHOUSE ROCK
$775 – Port Chester Residents
$850 - NON-Port Chester Residents

5th-10th Grade in September 2019 - ARTSCAMP (Theater Arts Academy) & SHOW - BYE BYE BIRDIE YOUTH
$775 – Port Chester Residents
$850 – NON-Port Chester Residents

AFTERNOON ONLY (1-4pm) Theater Production:
1st-4th Grade in September 2019 - SHOW ONLY- SCHOOLHOUSE ROCK
$175 – Port Chester Residents
$250 - NON-Port Chester Residents

5th-10th Grade in September 2019 - SHOW ONLY- BYE BYE BIRDIE YOUTH
$175 – Port Chester Residents
$250 - NON-Port Chester Residents

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Grade in September 2019 *
Child's Birth date *
MM
/
DD
/
YYYY
Home Address: *
Your answer
School: *
Your answer
CHOOSE 1 OPTION *
CAMPERS ENTERING 5th-10th grades ONLY, please choose from one of the following focus programs:
Parent Name *
Your answer
Additional Parent Name
Your answer
Preferred Phone Number *
Your answer
Preferred Email Address *
Your answer
I understand that I will have to mail the NON-REFUNDABLE $100 deposit by JUNE 11th, 2019 to secure my spot. *
Required
Emergency Contact #1 - Name and phone # *
Your answer
Emergency Contact #2 - Name and phone # *
Your answer
List any other people that have permission to pick up your child:
Your answer
Child’s Physician *
Your answer
Child’s Physician's Phone # *
Your answer
Please list any medical limitations or allergies that your child may have:
Your answer
Please add anything you would like us to know about your child, their health or their social/emotional well being.
Your answer
Submit
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