2015 SUMMER ART SHACK REGISTRATION FORM
A funky little shack offering art lessons for all ages!Student’s Name: _________________________________________________
Phone: ________________________ Age: ______ Grade in Fall ‘15:_______
Parent/Guardian’s Name: __________________________________________
Mailing Address: _________________________________________________
E-mail Address (parent):___________________________________________
Each day at the ART SHACK is a new adventure! With friends, a lot of materials, and your amazing imagination….great art will be created and new techniques will be learned! The Art Shack believes that EVERYONE is capable of creating art! Art is about self expression and enjoying the creative process. We will learn new techniques as well as create some “finished” art pieces! If you are really interested in creating something specific, or using a specific material please let us know! Come for the whole week, or pick a few days! Classes are best for rising 1st grade through high school age and are customized per student!
Check anything that sounds fun: __ Wants to draw people better __would like to draw a city __ I like to draw made up things __ I like abstract art __ I prefer realistic art __ I like to draw animals __ I like bright colors __ I like to draw in black and white __ I like to make a mess __ I like to build things __ painting is fun __ I want to learn to mix paint colors __ I want to learn to shade better __ I enjoy drawing designs __ I would like help with graphic design __ I would like to take better pictures __ I like to make collages __ I like fashion design __ I like comics
CAMP is from 9-12:00 Monday through Friday on these dates:
(Please circle which week you are attending)
Monday, July 13 thru Friday, July 17
Monday, July 20 thru Friday, July 24
(during the same week) 2 days: $70; 3 days: $100; 5 days: $140 ($125 for returning week long students)
Total enclosed: ___________
(Checks can be made payable to Elizabeth Miller& mailed to:
the Art Shack 165 Hampton Road, Winston-Salem, NC 27103)
** No refunds are given if there is not a minimum one week notice. All spots are filled, and you are committing to your spot! Classes are subject to being cancelled if there is not a minimum of 6 kids enrolled.
Consent: I authorize Elizabeth Miller to seek appropriate medical attention for my child, including the right to authorize medical treatment in my absence. I understand that I am financially responsible for all medical treatment. My child’s photo may be taken and used in “Art Shack” publicity unless I request otherwise in writing. Parent’s signature: __________________________
Medication currently taking: _________________________________________
** DRESS FOR A MESS If you have a sketchbook, please bring it. We will practice art techniques as well as complete finished art pieces over the course of the week!
Questions? Please call Elizabeth at 399-0707 or e-mail firstname.lastname@example.org