Rainier Arts Center: 2016 Summer Camp Registration Form
Rainier Arts Center and Anything Is Possible Theatre are bringing theatre summer camp back to Columbia City!

$300 per person per session
For ages 6 to 12
Located at Rainier Arts Center - 3515 S Alaska St Seattle, WA 98118
(formerly Rainier Valley Cultural Center in Columbia City)

Session #1: Monday, August 15-19, 2016 - 9am to 3pm
Session #2: Monday, August 22-26, 2016 - 9am to 3pm
After care available from 3pm to 5:30pm for $20 per day

A limited number of scholarships are available for eligible campers. Please indicate if you would like your child to be considered for scholarship enrollment.

Enrollment will be filled in the order registrations and payments are received.
Maximum 20 students per session.

This form can also be printed, filled out, and mailed to:
SEEDArts Attn: Rainier Arts Center 5117 Rainier Ave S. Seattle, WA 98118

Applying for session *
Camper's Name *
Your answer
Preferred Nickname
Your answer
Age *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Camper's phone number
If different than parent/guardian phone number
Your answer
Ok to text the above number?
Camper email address
If different than parent's/guardian's email address
Your answer
Parent/Guardian (#1) Name *
Your answer
Address *
Your answer
Phone number *
Your answer
Ok to text the above phone number? *
Email address *
Your answer
Parent/Guardian (#2) name
Your answer
Address
Your answer
Phone number
Your answer
Ok to text the above number?
Email address
Your answer
Emergency Contact Name (#1) *
Who is authorized to pick up child (other than parents/guardians)?
Your answer
Relationship to camper *
Your answer
Address *
Your answer
Phone number *
Your answer
Ok to text the above number? *
Emergency Contact Name (#2)
Who is authorized to pick up child (other than parents/guardians)?
Your answer
Relationship to camper
Your answer
Address
Your answer
Phone number
Your answer
Ok to text the above number?
Which day(s) during the session would you like to sign up for after care for your child?
After care is available from 3pm to 5:30pm for $20 per day. This will be added to your registration fee.
What is your child's t-shirt size? *
Please describe any previous experience your child has had with drama/theatre activities. (No previous experience is necessary.)
Your answer
What is your child most looking forward to about attending this theatre summer camp?
Your answer
Does your child have any concerns or worries about the theatre summer camp? (Please describe.)
Your answer
Does your child have any pressing medical/psychological/behavioral issues we should know about?
Your answer
Is there anything else you would like us to know about your child?
Your answer
Would you like your child to be considered for scholarship enrollment?
Please complete this separate scholarship application form: http://goo.gl/forms/aVnIkoiVH7
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