Application Received On:
Confirmation -
Send:
 Sent:

_______________________________________________________________________

ENROLLMENT APPLICATION
VALLEY VILLAGE CAMPUS
_______________________________________________________________________

STEP 1: PARENT INFORMATION
To begin, type in all necessary family information. A working Email
address is required as most camp communications are sent this way.
(This is NOT the K CAMP application)
_______________________________________________________________________

Are you a new, friend or returning family?
I am attending:
Days I will be attending:
Enroll me with my friends:

MOM
First Name
Last Name
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Email
_______________________________________________________________________

DAD or SECOND GUARDIAN
First Name
Last Name
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Email
_______________________________________________________________________
Emergency Contact(s)
Phone Number
Family Doctor
Phone Number
Authorized person(s) to pick up my child(ren)
_______________________________________________________________________

STEP 2: HOW DID YOU HEAR ABOUT US?
In an effort to better target our marketing campaigns, please let
us know where you first heard about our program.
______________________________________________________________________
LA Parent
Friend
Flyer
LA Family
Banner
Internet
Postcard
At School
Other

STEP 3: YOUR FIRST CHILD'S INFORMATION
Complete all fields below for the first child you are enrolling
______________________________________________________________________
First Name
Last Name
Sex
Age in June
School
Current Grade

If you can, enroll me with my friends
I am attending camp alone
______________________________________________________________________

STEP 4: WORKSHOP CHOICES FOR YOUR FIRST CHILD
You are now ready to select your first child's workshops. Please rememeber to
check daily workshop schedules BEFORE making your choices as some workshops
may already be closed. You and your child should select two choices of workshops
within each of the four time periods as your first choice may close between
the time you complete your application and the time we receive it.
If so, we will automatically enter your child into their second choice.
Valley Village Campus
Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30

Time
1st Choice
2nd Choice
9:00 - 10:10
10:35 - 11:45
12:45 - 1:55
2:20 - 3:30
______________________________________________________________________

STEP 5: TUITION CALCULATION
Please select all the sessions you are enrolling in. Decide if you will
need extended care, which is billed at $7 per hour if you sign up in
advance, or if you want your child(ren) to have a camp T-Shirt.
Then add up all amounts selected and enter your
total tuition payment where indicated below.
MY FIRST CHILD....
IS ENROLLING IN
(enter your child's name above)
and
Camp Merchandise, double click name to see item
do you want a camp shirt?
do you want a lunch box and water bottle?
do you want a camp hat?
____________________________________________________________________

Use a calculator, total tuition is NOT automatically entered.
MY TOTAL TUITION IS...

Please Note:
Material fees, if any, will be billed when we process your application.
If you will be paying by credit card, material fees,
if any, will be charged at that time.
If paying by check, we will bill you for any outstanding material fees due.
____________________________________________________________________

STEP 6: PAYMENT METHOD
How would you like to pay for camp tuition?
If you pay by check, just mail the total tuition (above)
in with your completed application.
If you elect to pay by credit card an additional 3%
will be added to total tuition fees.
We do not accept American Express.
Make Checks Payable to: The Summer Art Academy

Card Type
Cardholder Name
Account Number
Expiration Date
CARDHOLDER SIGNATURE: __________________________________________
(Sign above after you have printed out your completed application)
____________________________________________________________________

STEP 7: TERMS AND CONDITIONS
Please read our policy and enrollment conditions listed below.
Registration cannot be completed without signing and clicking the accept box below
I ACCEPT:

DATE: ______________

PARENT/GUARDIAN SIGNATURE: ______________________________________
(Sign above after you have printed out your completed application.
By signing above you accept all our terms and conditions.)
____________________________________________________________________

STEP 8: MEDICAL INFORMATION FORM
Please click below to open up the camp medical form.
When complete, print this out and mail with your applciation.
Your child will NOT be enrolled in workshops
without a completed medical form!

MEDICAL FORM
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STEP 9: ORDER A FRESH LUNCH FOR YOUR KIDS
Please click the Fresh Lunches bar below to register for camp lunches and snacks.
If you have signed up for extended care make sure you order an after camp snack!

____________________________________________________________________

THAT'S IT! NOW PRINT OUT YOUR COMPLETED
APPLICATION AND SIGN WHERE REQUIRED.
Along with your completed and signed medical form, mail it in with your tuition check to:

4130 Greenbush Ave. Sherman Oaks, CA. 91423.

All applications must be MAILED in and are
processed in the order which they are received.

NOW JUST WATCH FOR YOUR CONFIRMATION OF
ENROLLMENT TO MOM'S EMAIL ADDRESS.
SEE YOU AT CAMP!