Registration for Multi-Arts 2017 Summer Camp
To complete registration for any of the 2017 Multi-Arts Summer workshops you must:

•Complete this online registration and submit
•Sign and return Release of Liability Agreement (via email)
•Send certification of up-to-date immunizations/most recent physical exams (via mail, email, fax 413-584-7951)
•send tuition payment and a non-refundable $45.00 registration fee/per family/per calendar year..

Full tuition refund if you withdraw before May 31, 2017

Payments and copies of medical records and Liability Agreement can be email to info@multi-arts.org or sent to:

Multi-Arts
PO Box 108
Hadley, MA 01035

Email address *
Registration
Workshops II, III, IV and V will be held at Wildwood School in Amherst.
Workshop I at Immanuel Church, Amherst
You can change workshop dates before May 31. After this date a $35 FEE will be applied
Which workshop(s) are you registering for? Full tuition refund if you withdraw before May 31, 2017 *
Workshop II, III & IV will culminate in a theatrical production at the end of the session.
Required
If you want to sign up one week of the two-week workshop. Please let us know the dates
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Register for: *
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's age *
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Child's DOB *
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DD
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YYYY
Sex *
Parent/Guardian #1 Name *
Your answer
Parent/Guardian #1 Town *
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Optional: Parent/Guardian #1 Work/Day Phone
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Parent/Guardian #1 Cell Phome *
Write N/A if no cell phone
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Best way to contact in an emergency *
Parent/Guardian #1 Email *
Note: All communications will be conducted via email. Be sure you accept emails from multiarts.org@gmail.com & info@multi-arts.org
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Optional: Parent/Guardian #2 Name
Your answer
Optional: Parent/Guardian #2 Work/Day Phone
*if different
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Optional: Parent/Guardian #2 Cell Phome
*if different
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Optional: Parent/Guardian #2 Email
Note: All communications will be conducted via email
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Optional, Transportation
I authorize the following people to pick my child up from the program:
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First Aid *
Required
Does child has any life threatening allergies?
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Is there any information staff should know to help your child have a successful and fun day?
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Photograph and Video Release *
No profit will be made from these recordings, and the names of the children will not appear next to the images.
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How did you learn about this program: *
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If you choose OTHER, please explain bellow:
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Payment method *
You can either mail in a check or pay online via Paypal (www.multi-arts.org/summer-camp-2017).
Signature
By typing my name below, I agree that I have reviewed the following information and verify that it is correct. My name and initials below denote a virtual signature, and agreement to the terms and conditions of registration.
Parent’s Virtual Signature (Typed Full Name) *
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Submit and pay online or send check with full payment of tuition to Multi-Arts - PO Box 108 - Hadley, MA 01035.
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