Perkins Summer Arts Camp Registration Form
In an effort to safely and effectively ensure the highest quality instruction for all of our campers, please complete this form before your child's camp session begins. Enrollment in camp is subject to a thorough review and evaluation of the information provided. All applications are pending. There is a potential for assessment of tuition in the event that an initially enrolled student is later found ineligible.
CAMPER INFORMATION
Camper First Name, Middle Initial & Last Name *
Your answer
Camper Date of Birth *
MM
/
DD
/
YYYY
List ALL Camper Allergies (Include any helpful details) *
Your answer
Session (s) Attending at Perkins Moorestown *
Required
Session (s) Attending at Perkins Collingswood *
Required
Age at Time of Camp
Your answer
Camper's School and Location *
Your answer
Grade Completed *
Your answer
Parent(s)/Guardian(s) First and Last Name *
Your answer
Mailing Address (street, city, state & zip code) *
Your answer
Primary Phone *
Your answer
Secondary Phone *
Your answer
Email address *
Your answer
Emergency Contact's Full Name, Relationship, and Phone *
Your answer
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