2019 Summer art camp registration
Information is needed when registering for any summer art camp at Mayodan Arts Center.
*Activities in each session are thematic and include independent work as well as group setting work.
*Classes are limited to 12 participants and age requirements vary depending on week. Descriptions posted on flyer
*Camp hours are 10:00am-12:30pm, or 1:00pm-3:30pm. Healthy snacks will be provided.
*Prices are indicated next to each week.
Please type in all information below, making sure you answer each question. Please contact
for further assistance.
your email address
Name of child (first and last)
Parent or guardian name
Age and grade completed
Which week of art camp will your child attend?
June 11 and 12
June 17 and 18
June 24 and 25 Camp is 9:30 am-12 pm
June 27 and 28
July 8 and 9
July 16 and 17
July 23 and 24
July 30 and 31
Does your child have any allergies or medical concerns?
Parent or guardian address
Parent or guardian phone number (to be reached in case of emergency)
Partial payment due at sign up, remaining due first day of art camp
credit card (via Square, PayPal, Venmo)
Please submit payment directly to instructor Ashley Hickok or Kathy Anthony
Students are encouraged to wear comfortable clothing and/or appropriate for painting.
Parental Photograph release form, do you give Mayodan Arts Center permission to take or publish any photograph of your child?
I hereby release the Mayodan Arts Center, Instructor(s) and Art Camp assistants and staff, from all liability ofaccidents incurred by my child as a result of participating in the 2019 Summer Camps for kids.
Yes, I agree
No, I do not agree
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